Pre-endoscopic risk stratification identifies groups of patients at high and low risk of mortality, re-bleeding, and need for urgent treatment intervention following acute upper-gastrointestinal hemorrhage, according to a study published in May's European Journal of Gastroenterology & Hepatology.
A team from Cambridge, England, assessed the accuracy of pre-endoscopic risk stratification in patients with acute upper-gastrointestinal (GI) hemorrhage.
Over a 3-year period, 1349 consecutive patients with acute upper-GI hemorrhage, presenting to a single teaching hospital, were included in the study.
Each was prospectively risk stratified before endoscopy, and followed up for outcome.
The researchers evaluated 2-week all-cause mortality, re-bleeding, and need for urgent treatment intervention among the patients.
Stratification within the high-risk group predicted a significant increased risk of 2-week all-cause mortality, when compared with intermediate- and low-risk patients (12%, 3%, and 0%, respectively).
It also predicted significant elevated risk of re-bleeding (44%, 2%, and 0%, respectively), and need for urgent treatment intervention (71%, 41%, and 3%, respectively).
|Risk stratification predicts:|
- Urgent intervention
| European Journal of Gastroenterology & Hepatology |
Ewen A. Cameron, of Addenbrooke's Hospital, Cambridge, said on behalf of the group, "Over a 3-year period, medical staff at this institution have routinely used this risk stratification.
"It identifies groups of patients at high and low risk of mortality, re-bleeding, and need for urgent treatment intervention, following acute upper-GI hemorrhage."
"Use of this risk stratification should allow targeting of more intensive treatment where it might be of most benefit.
"Those patients at lowest risk from outpatient management are also identified," it was concluded.