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West Indian Medical Journal

Print version ISSN 0043-3144

Abstract

GIESE, A et al. Use of the complete Rockall score and the Forrest classification to assess outcome in patients with non-variceal upper gastrointestinal bleeding subject to after-hours endoscopy: a retrospective cohort study. West Indian med. j. [online]. 2014, vol.63, n.1, pp. 29-33. ISSN 0043-3144.

OBJECTIVES: To evaluate the usefulness of the Forrest classification and the complete Rockall score with customary cut-off values for assessing the risk of adverse events in patients with upper gastrointestinal bleeding (UGI-B) subject to after-hours emergency oesophago-gastro-duodenoscopy (E-EGD) within six hours after admission. METHODS: The medical records of patients with non-variceal UGI-B proven by after-hours endoscopy were analysed. For 'high risk' situations (Forrest stage Ia-IIb/complete Rockall score > 2), univariate analysis was conducted to evaluate odds ratio for reaching the study endpoints (30-day and one-year mortality, re-bleeding, hospital stay > 3 days). RESULTS: During the study period (75 months), 86 cases (85 patients) met the inclusion criteria. Patients' age was 66.36 ± 14.38 years; 60.5% were male. Mean duration of hospital stay was 15.21 ± 19.24 days. Mortality rate was 16.7% (30 days) and 32.9% (one year); 14% of patients re-bled. Univariate analysis of post-endoscopic Rockall score > 2 showed an odds ratio of 6.09 for death within 30 days (p = 0.04). No other significant correlations were found. CONCLUSION: In patients with UGI-B subject to after-hours endoscopy, a 'high-risk'Rockall score permits an estimation of the risk of death within 30 days but not of re-bleeding. A 'high-risk'Forrest score is not significantly associated with the study endpoints.

Keywords : After-hours care; digestive system; haemorrhage; risk scoring systems; upper gastrointestinal tract.

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