Risk Stratification for Patients with Upper Gastrointestinal Bleeding

Upper gastrointestinal (GI) bleeding (UGIB) is the most common GI emergency, and it is associated with significant morbidity and mortality. Early identification of low-risk patients suitable for outpatient management has the potential to reduce unnecessary costs, and prompt triage of high-risk patie...

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Main Author: Bong Eun Lee
Format: Article
Language:English
Published: Korean College of Helicobacter and Upper Gastrointestinal Research 2018-12-01
Series:The Korean Journal of Helicobacter and Upper Gastrointestinal Research
Subjects:
Online Access:http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2018.18.4.225
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author Bong Eun Lee
author_facet Bong Eun Lee
author_sort Bong Eun Lee
collection DOAJ
description Upper gastrointestinal (GI) bleeding (UGIB) is the most common GI emergency, and it is associated with significant morbidity and mortality. Early identification of low-risk patients suitable for outpatient management has the potential to reduce unnecessary costs, and prompt triage of high-risk patients could allow appropriate intervention and minimize morbidity and mortality. Several risk-scoring systems have been developed to predict the outcomes of UGIB. As each scoring system measures different primary outcome variables, appropriate risk scores must be implemented in clinical practice. The Glasgow-Blatchford score (GBS) should be used to predict the need for interventions such as blood transfusion or endoscopic or surgical treatment. Patients with GBS ≤1 have a low likelihood of adverse outcomes and can be considered for early discharge. The Rockall score was externally validated and is widely used for prediction of mortality. The recently developed AIMS65 score is easy to calculate and was proposed to predict in-hospital mortality. The Forrest classification is based on endoscopic findings and can be used to stratify patients into high- and low-risk categories in terms of rebleeding and thus is useful in predicting the need for endoscopic hemostasis. Early risk stratification is critical in the management of UGIB and may improve patient outcome and reduce unnecessary health care costs through standardization of care.
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spelling doaj-art-2f5ae97fd8c645bcb0c6015afec501822025-08-20T03:33:10ZengKorean College of Helicobacter and Upper Gastrointestinal ResearchThe Korean Journal of Helicobacter and Upper Gastrointestinal Research1738-33312018-12-0118422523010.7704/kjhugr.2018.18.4.225kjhugr.2018.18.4.225Risk Stratification for Patients with Upper Gastrointestinal BleedingBong Eun Lee0Department of Internal Medicine, Pusan National University School of Medicine, Busan, KoreaUpper gastrointestinal (GI) bleeding (UGIB) is the most common GI emergency, and it is associated with significant morbidity and mortality. Early identification of low-risk patients suitable for outpatient management has the potential to reduce unnecessary costs, and prompt triage of high-risk patients could allow appropriate intervention and minimize morbidity and mortality. Several risk-scoring systems have been developed to predict the outcomes of UGIB. As each scoring system measures different primary outcome variables, appropriate risk scores must be implemented in clinical practice. The Glasgow-Blatchford score (GBS) should be used to predict the need for interventions such as blood transfusion or endoscopic or surgical treatment. Patients with GBS ≤1 have a low likelihood of adverse outcomes and can be considered for early discharge. The Rockall score was externally validated and is widely used for prediction of mortality. The recently developed AIMS65 score is easy to calculate and was proposed to predict in-hospital mortality. The Forrest classification is based on endoscopic findings and can be used to stratify patients into high- and low-risk categories in terms of rebleeding and thus is useful in predicting the need for endoscopic hemostasis. Early risk stratification is critical in the management of UGIB and may improve patient outcome and reduce unnecessary health care costs through standardization of care.http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2018.18.4.225Risk stratificationUpper gastrointestinal bleeding
spellingShingle Bong Eun Lee
Risk Stratification for Patients with Upper Gastrointestinal Bleeding
The Korean Journal of Helicobacter and Upper Gastrointestinal Research
Risk stratification
Upper gastrointestinal bleeding
title Risk Stratification for Patients with Upper Gastrointestinal Bleeding
title_full Risk Stratification for Patients with Upper Gastrointestinal Bleeding
title_fullStr Risk Stratification for Patients with Upper Gastrointestinal Bleeding
title_full_unstemmed Risk Stratification for Patients with Upper Gastrointestinal Bleeding
title_short Risk Stratification for Patients with Upper Gastrointestinal Bleeding
title_sort risk stratification for patients with upper gastrointestinal bleeding
topic Risk stratification
Upper gastrointestinal bleeding
url http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2018.18.4.225
work_keys_str_mv AT bongeunlee riskstratificationforpatientswithuppergastrointestinalbleeding