Endoscopy 2019; 51(04): S251
DOI: 10.1055/s-0039-1681927
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Stomach and small intestine ePosters
Georg Thieme Verlag KG Stuttgart · New York

TEN YEARS OF UPPER GASTROINTESTINAL BLEEDING IN A LARGE VOLUME EMERGENCY DEPARTMENT

M Lomré
1   ULB Brussels, Brussels, Belgium
,
P Mols
2   Department of Emergency, CHU St-Pierre, ULB Brussels, Brussels, Belgium
,
P Kirkove
3   CHU St-Pierre, ULB Brussels, Brussels, Belgium
,
P Eisendrath
4   Department of Gastroenterology, CHU St-Pierre, ULB Brussels, Brussels, Belgium
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

To analyse the etiologies of upper gastrointestinal bleeding (UGIB) in a public hospital from the city centre of Brussels.

To test two risk scores – Rockall Score (RS) and Glasgow-Blatchford Score (GBS) – in UGIB and to analyse how they perform for predicting outcomes.

Methods:

Based on in-hospital records, we retrospectively studied 243 adults who were hospitalized from the emergency room for UGIB between the 01/01/2004 and the 31/12/2014 at the CHU St Pierre in Brussels, Belgium.

We collected data regarding etiologies of UGIB, need of intervention (blood transfusion, endoscopic therapy, surgical treatment), the rebleeding rate and in-hospital mortality.

We applied RS and GBS to respectively 238 and 242 patients.

Results:

The most common etiology of UGIB was peptic ulcer (67,9%). No etiology was found for 12,4% of patients.

Regarding interventions, 57,2% of patients required blood transfusion, 42,8% needed endoscopic therapy and 7,4% underwent surgery. Rebleeding rate was 11,9%. Mortality was 6,6%.

The RS had a greater discriminating capacity for mortality risk (AUC 0.82) than for predicting rebleeding rate (AUC 0.65).

The GBS had a similar discriminating capacity for mortality (AUC 0.76) and for blood transfusion (AUC 0.86) and was less discriminant for the need of intervention (AUC 0.65).

Applying the usual threshold for management of UGIB as outpatients (≤1), GBS identified correctly 106/107 patients who needed intervention, but one patient with a score of 0 needed transfusion and endoscopic therapy.

Conclusions:

Despite major advances in management of UGIB, mortality remains significant in our inpatient population where peptic ulcer remains the principal cause of UGIB.

The GBS is an interesting discrimination tool regarding mortality and for predicting the need of blood transfusion. The need of excluding patients with recent abdominal surgery from GBS for outpatient management assessment should be evaluated in larger prospective studies.