Forbes J Med. 2022; 3(3): 314-320 | DOI: 10.4274/forbes.galenos.2022.36450

Acil Servise Üst Gastrointestinal Sistem Kanamasý ile Baþvuran Hastalarda Glasgow-Blatchford ve Rockall ve Pre-Rockall Skorlama Sistemlerinin Faydalarýnýn Retrospektif Analizleri

Kemal GÖKÇEK¹, Murat ERSEL², Yusuf Ali ALTUNCI², Funda KARBEK AKARCA², Selahattin KIYAN^2
1Ýzmir Demokrasi Üniversitesi Buca Seyfi Demirsoy Eðitim ve Araþtýrma Hastanesi, Acil Týp Kliniði, Ýzmir, Türkiye
²Ege Üniversitesi Týp Fakültesi, Acil Týp Anabilim Dalý, Ýzmir, Türkiye

Amaç: Risk skorlamasý üst gastrointestinal sistem (GÝS) kanamalarýnda hastanýn tedavi ve takibini belirleyen anahtar roldedir. Bu çalýþmada amaç üst GÝS kanamalarýnda Rockall skoru (RS) ve Blatchford skorlarýnýn öngörü baþarýsýný ölçmektir.
Yöntem: Bu geriye dönük çalýþmada, 2010-2012 yýllarý arasýnda acil servisimize 18 yaþ üstü, üst GÝS kanamasý ile baþvuran hastalar dahil edildi. Toplamda 423 hasta çalýþmaya dahil edildi. Pre-endoskopik Rockall (PRS), tam Rockall ve Blatchford skorlarý hesaplandý. Bu üç skorlamanýn ve þok indeksinin hastalarda yüksek riskli hasta, transfüzyon ve mortalite öngürüleri istatistiksel olarak hesaplandý.
Bulgular: Dört yüz yirmi üç hastadan 293’ü (%69,3) erkek ve ortalama yaþ 63,7±15,7 yýl idi. Hastalarýn baþvuru þikayetlerinde melena sýklýðý %78 (n=330), hematemez %49,6 (n=210), senkop %12,1 (n=51) hesaplandý. Ortalama PRS 3,15±1,61, RS 5,05±2,13, Blatchford skoru 10,19±3,78, SI 0,82±0,25 olarak hesaplandý. Transfüzyonu öngörmede Blatchford skorunun en baþarýlý olduðu bulundu. Yüksek riskli hastayý öngörmede RS ve Blatchford skoru en baþarýlý skorlardý. Çalýþmamýzda mortalite oraný %5,7 (n=24) olup, RS tahminde en deðerli skordu.
Sonuç: Risk skorlarý transfüzyon, yatýþ ihtiyacý ve mortalite için düþük ve yüksek riskli hastalarý belirleyerek, hastalarýn tedavilerini yönlendirmede klinisyen tarafýndan güvenle kullanýlabilir.

Anahtar Kelimeler: Üst gastrointestinal sistem kanamasý, þok indeksi, Rockall skoru, Blatchford skoru

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Retrospective Analyses of the Utility of Glasgow-Blatchford and Rockall and Pre-Rockall Scoring Systems in Patients Admitted to the Emergency Department with Upper Gastrointestinal System Bleeding

Kemal GÖKÇEK¹, Murat ERSEL², Yusuf Ali ALTUNCI², Funda KARBEK AKARCA², Selahattin KIYAN^2
1Buca Seyfi Demirsoy Training And Research Hospital, Emergency Medicine, Izmir
²Ege University, Faculty Of Medicine, Department Of Emergency Medicine, Ýzmir

Objective: Risk scoring is the key point of the upper gastrointestinal bleeding (GIB) which determines the management of the patient. In this study our aim is to measure the success of Rockall score (RS) and Blatchford score that are frequently used in upper GIB.
Methods: In this retrospective descriptive type of study, the patients over 18 years of age who referred to emergency department with upper GIB between the years 2010-2012 were included. A total of 423 patients were included in study. Pre-endoscopic Rockall (PRS), complete RS and Blatchford scores are calculated. High-risk patient, transfusion and mortality predictions of these three scoring and shock index (SI) were calculated statistically.
Results: Of the 423 patients 293 (69.3%) were males and mean age was 63.7±15.7 years. The frequency of melena was 78% (n=330), hematemesis 49.6% (n=210), and syncope 12.1% (n=51) in the patients’ complaints at admission. Mean PRS was 3.15±1.61, RS was 5.05±2.13, Blatchford score was 10.19±3.78, and SI was 0.82±0.25. Blatchford score was found to be the most successful in predicting transfusion. RS and Blatchford score were the most successful scores in predicting the high-risk patient. In our study, the mortality rate was 5.7% (n=24), and the RS was the most valuable score in estimation.
Conclusion: By identifying low and high risk patients for transfusion, need for hospitalization, and mortality, risk scores can be used safely by the clinician to guide the treatment of patients.

Keywords: Upper gastrointestinal bleeding, shock index, Rockall score, Blatchford score

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