Risk Stratification for Patients with Upper Gastrointestinal Bleeding
Korean J Helicobacter Up Gastrointest Res 2018;18(4):225-230
Published online December 10, 2018
© 2018 Korean College of Helicobacter and Upper Gastrointestinal Research.

Bong Eun Lee

Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
Correspondence to: Bong Eun Lee
Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea
Tel: +82-51-240-7869, Fax: +82-51-244-8180, E-mail: bongsul@daum.net
Received January 26, 2018; Revised April 9, 2018; Accepted April 13, 2018.
The Korean Journal of Helicobacter and Upper Gastrointestinal Research is an Open-Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Keywords : Risk stratification, Upper gastrointestinal bleeding

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