Blatchford and Rockall Systems in the Prediction of Upper Gastrointestinal Bleeding

Abstract

Background:

Acute upper gastrointestinal bleeding (UGIB) is a common and life-threatening problem. The identification of high-risk patients with regard to the need for urgent endoscopy and immediate intervention in patients with acute UGIB is a challenge for emergency physicians. The use of Rockall and Blatchford scoring systems has diminished this challenge to some extent. Therefore, the aim of this study was to investigate the role of Blatchford and Rockall systems in the outcomes of patients with UGIB referred to Emergency Department of Shahid Beheshti Hospital in Qom.

Materials and Methods:

In this retrospective analytic study, using a checklist of Blatchford and Rockall Scoring Systems and an easy sampling method, the clinical records of 194 patients with UGIB who aged over 18 years and had no trauma referring from 2013to 2016 to the Emergency Department of Shahid Beheshti Hospital  were studied. The role of Blatchford and Rockall Scoring Systems was investigated by Statistical tests regard to the significance level of p=0.05.

Results:

This study showed a significant relationship between the interventions for patients with UGIB in Shahid Beheshti Hospital with predicted interventions by the Blatchford Scoring System (p =0.000, kappa = 0.294). Also, there was a significant relationship between the place of admission of patients in Shahid Beheshti Hospital with predicted place of hospitalization determined by Rockall (p =0.000, kappa=0.182). Also, there was a significant relationship between age and Rockall Scoring System (p < 0.00001).

Conclusion:

The Blatchford Scoring System can be used as a clinical guide to determine the type of treatment intervention immediately and in the emergency department as a clinical guide to determine the type of patient's care.