[Glasgow-Blatchford usefulness in patients with non variceal upper gastrointestinal bleeding with low and high risk of complications seen at the Emergency Department of Santo Tomas Hospital, 2015-2016]

Rev Gastroenterol Peru. 2019 Apr-Jun;39(2):105-110.
[Article in Spanish]

Abstract

Introduction: The Glasgow-Blatchford (GBS) scale allows us to classify the patient as a high or low risk of presenting complications.In the patients identified as "low risk", the performance of an early endoscopy could reduce the intrahospital days and the overall cost. In our environment, we do not know the usefulness of the GBS scale.

Objective: To describe the utility of the Glasgow-Blatchford scale (GBS) in the stratification of risk in patients with non-variceal upper gastrointestinal bleeding (HDA) seen in the emergency department of a tertiary hospital.

Materials and methods: 218 patients were prospectively included, and they were performed in the first 24-48 hr an urgent endoscopy. These were stratified, according to the GBS scale, at low risk (GBS ≤ 2), and high risk (GBS ≥ 3). We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the GBS scale in our setting based on the requirement of endoscopic, radiological treatment (arterial embolization), transfusion of blood products and / or surgery, as our gold standar to classify patients as "high risk".

Results: A total of 218 patients were included, with a mean age of 56 ± 18 years, of which 121/218 (55%) were male. 156/218 required intervention for what were classified as "high risk" while 62/218 did not specify and classified as "low risk". A cut-off value of GBS ≤ 2 showed a sensitivity of 98% with a NPV of 100%. The utility of the GBS scale showed an area under the ROC curve 0.83 (95% CI 0.75-0.90).

Conclusion: The GBS scale used in patients with non-variceal UGB attended in the emergency department has adequate diagnostic validity to predict the need for intervention.

MeSH terms

  • Adult
  • Aged
  • Emergency Service, Hospital
  • Emergency Treatment*
  • Female
  • Gastrointestinal Hemorrhage / complications
  • Gastrointestinal Hemorrhage / epidemiology*
  • Gastrointestinal Hemorrhage / therapy*
  • Hospitals
  • Humans
  • Male
  • Middle Aged
  • Panama
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Assessment*
  • Sensitivity and Specificity
  • Tertiary Care Centers
  • Time Factors
  • Upper Gastrointestinal Tract*