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News

Tool for predicting the need for intervention in cancer patients with upper GI bleeding

Blatchford score is a useful tool for predicting the need for intervention in cancer patients with upper gastrointestinal bleeding, reports the latest issue of the Journal of Gastroenterology & Hepatology.

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The Blatchford score is based on clinical and laboratory variables to predict the need for clinical interventions in upper gastrointestinal bleeding.

Dr Shin Ahn and colleagues from Korea evaluated the Blatchford score with clinical and full Rockall scores in patients with active cancer presenting to the emergency department with upper gastrointestinal bleeding.

The secondary object was to assess the accuracy of the Blatchford score at different source of upper gastrointestinal bleeding cancer bleeding versus non-malignant lesions.

The research team reviewed and extracted data from electronic medical record on patients with active cancer presenting to the emergency department from 2009 to 2011.

Clinical interventions included blood transfusion, therapeutic endoscopy, angiographic intervention, and surgery.

The Blatchford score was superior to clinical Rockall
Journal of Gastroenterology and Hepatology

Of the 225 patients included, 197 received interventions.

The researchers found that the Blatchford score was superior to clinical Rockall and full Rockall score in predicting interventions.

When the score of 2 or less is counted as negative, sensitivity of 0.99 and specificity of 0.54 were calculated.

When the patients were separated according to the source of upper gastrointestinal bleeding, sensitivity and specificity were not changed.

Dr Ahn's team concluded, "The Blatchford score outperformed both Rockall scoring system in predicting intervention in patients with active cancer."

"The source of bleeding was not important factor in the score performance."

"The Blatchford score has a very good sensitivity."

"However, suboptimal specificity limits its role as sole means of decision making in cancer patient with upper gastrointestinal bleeding."

J of Gastroenterol and Hepatol 2013: 28(8) 1288–1294
30 August 2013

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