Clinical outcomes of acute upper gastrointestinal bleeding according to the risk indicated by Glasgow-Blatchford risk score-computed tomography score in the emergency room
- 주제(키워드) Gastrointestinal hemorrhage , Upper gastrointestinal tract , Multidetector computed tomography , Risk assess-ment
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Lee, Hyun Ae; Jung, Hye-Kyung; Kim, Tae Oh; Byeon, Ju-Ran; Jeong, Eui-Sun; Cho, Hyun-Ji; Tae, Chung Hyun; Moon, Chang Mo; Kim, Seong-Eun; Shim, Ki-Nam; Jung, Sung-Ae] Ewha Womans Univ, Coll Med, Dept Internal Med, Seoul, South Korea; [Jung, Hye-Kyung] Ewha Womans Univ, Dept Internal Med, Med Ctr, 1071 Anyangcheon Ro, Seoul, South Korea
- 등재 SCIE, KCI등재
- OA유형 gold
- 발행기관 KOREAN ASSOC INTERNAL MEDICINE
- 발행년도 2022
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000203095
- 본문언어 영어
- Published As https://doi.org/10.3904/kjim.2022.099
- PubMed https://pubmed.ncbi.nlm.nih.gov/36375488
초록/요약
Background/Aims: Acute upper gastrointestinal (UGI) bleeding is a significant emergency situation with a mortality rate of 2% to 10%. Therefore, initial risk stratification is important for proper management. We aimed to evaluate the role of con-trast-enhanced multidetector computed tomography (MDCT) for risk stratification in patients with acute UGI bleeding in the emergency room (ER). Methods: This retrospective study included patients with UGI bleeding in the ER. Glasgow-Blatchford risk score-computed tomography (GBS-CT) was assessed using a combination of GBS and the MDCT scan scoring system.Results: Of the 297 patients with UGI bleeding, 124 (41.8%) underwent abdominal MDCT. Among them, 90.3% were clas-sified as high-risk by GBS, and five patients died (4.0%). Rebleeding occurred in nine patients (7.3%). The high-risk GBS-CT group had significantly higher in-hospital mortality (10.5% in high-risk vs. 1.4% in moderate risk vs. 0% in low-risk, p = 0.049), transfusion amount (p < 0.001), and endoscopic hemostasis (p < 0.001) compared to the moderate-and low-risk groups.Conclusions: Adding MDCT scans to the existing validated prognosis model when predicting the risk of UGI bleeding in patients in the ER plays a significant role in determining in-hospital mortality, transfusions, and the need for endoscopic he-mostasis.
more