Abstract

KAROL RAMIREZ, John; MENENDEZ RIVERA, Berta María  and  COBIELLAS RODRIGUEZ, Roberto. Behavior and Rockall risk scoring in the non-variceal upper gastrointestinal bleeding. Rev Cubana Cir [online]. 2014, vol.53, n.1, pp. 17-29. ISSN 0034-7493.

Introduction: Non-variceal upper gastrointestinal bleeding is a current surgical emergency of difficult management. This fact prompted the authors to find out its behavior and to use Rockall risk scoring system to determine the risk of suffering adverse effects during the recovery period, those patients that may be early discharged and the causes that prevent it. Methods: Cross-sectional descriptive study conducted in 182 patients from "Ernesto Guevara de la Serna" general teaching hospital, who were seen in the period of 2009 through 2010. Results: Males were the most affected (54.4 %) and the 60-80 years age group registered the highest number of cases. Gastroduodenal ulcer was the first cause (52.7 %). The initial manifestation was tarry stools in 64 % of cases. Blood hypertension was the most frequent comorbidity (60.7%). In the study group, 44.5% of patients needed blood transfusion. The mortality rate was 8.2 %. Most of patients were classified as intermediate risk cases according to Rockall system (40.1 %). Just 11.5 % of patients were early discharged since the hemodynamic instability (38 %) was the main responsible for this low number. Rockall risk scoring system showed 98.3% sensitivity, 56.9% specificity, 52.3 % positive predictive value, 98.6% negative predictive value and 70.9 % accuracy. The only complication in low risk patients were relapse (1.4 %). Conclusions: Early discharge from hospital occurs in low Rockall risk score patients provided that special attention is paid to hemodynamic stability.

Keywords : non-variceal upper gastrointestinal hemorrhage; Rockall risk scoring; gastroduodenal peptic ulcer; erosive hemorrhagic gastritis.

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