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Gaceta médica de México
versão On-line ISSN 2696-1288versão impressa ISSN 0016-3813
Resumo
OLIVAREC-BONILLA, Miroslava; GARCIA-MONTANO, Anaidt M. e HERRERA-ARELLANO, Armando. Upper gastrointestinal hemorrhage re-bleeding risk according to the Glasgow-Blatchford scale: a triage tool. Gac. Méd. Méx [online]. 2020, vol.156, n.6, pp.502-508. Epub 27-Maio-2021. ISSN 2696-1288. https://doi.org/10.24875/gmm.20005607.
Introduction:
The Glasgow-Blatchford scale (GBS) classifies the risk of re-bleeding after upper gastrointestinal bleeding (UGIB) using clinical data, whereas the Forrest and Dagradi scales do it by endoscopy.
Objective:
To assess GBSs ability to identify re-bleeding risk within 30 days of an UGIB, using endoscopy as the gold standard for comparison.
Method:
129 medical records of patients with UGIB and endoscopy were analyzed. The Glasgow-Blatchford, Forrest and Dagradi scales were quantified; sensitivity, specificity and area under the ROC curve (AUC-ROC) of GBS-reported re-bleeding risk were calculated.
Results:
GBS identified 53 patients with low re-bleeding risk (41.09 %) and 76 with high risk (58.91 %). Endoscopy identified 107 patients with non-variceal bleeding (82.94 %): 98 with low risk (89.9 %) and 11 with high risk (10.09 %); in addition, it identified 22 patients with variceal hemorrhage (17.05 %): 12 with low risk (54.54 %) and 10 with high risk (45.45 %). GBS showed a sensitivity of 0.857, specificity of 0.462 and an AUC-ROC of 0.660.
Conclusions:
GBS is simple, objective and useful to identify the risk of re-bleeding after UGIB; it is suggested as a triage tool in the emergency department.
Palavras-chave : Upper gastrointestinal hemorrhage; Re-bleeding risk; Endoscopy; Glasgow-Blatchford scale; Forrest scale; Dagradi scale.