The Korean journal of helicobacter and upper gastrointestinal research (대한상부위장관⦁헬리코박터학회지)

Korean College of Helicobacter and upper Gastrointestinal Reseaarch (대한상부위장관ㆍ헬리코박터학회)
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Risk Stratification for Patients with Upper Gastrointestinal Bleeding

상부위장관 출혈 환자에서 위험의 계층화와 이에 따른 치료 전략

  • Lee, Bong Eun (Department of Internal Medicine, Pusan National University School of Medicine)
  • 이봉은 (부산대학교 의학전문대학원 내과학교실)
  • Received : 2018.01.26
  • Accepted : 2018.04.13
  • Published : 2018.12.31
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Abstract

Upper gastrointestinal (GI) bleeding (UGIB) is the most common GI emergency, and it is associated with significant morbidity and mortality. Early identification of low-risk patients suitable for outpatient management has the potential to reduce unnecessary costs, and prompt triage of high-risk patients could allow appropriate intervention and minimize morbidity and mortality. Several risk-scoring systems have been developed to predict the outcomes of UGIB. As each scoring system measures different primary outcome variables, appropriate risk scores must be implemented in clinical practice. The Glasgow-Blatchford score (GBS) should be used to predict the need for interventions such as blood transfusion or endoscopic or surgical treatment. Patients with GBS ${\leq}1$ have a low likelihood of adverse outcomes and can be considered for early discharge. The Rockall score was externally validated and is widely used for prediction of mortality. The recently developed AIMS65 score is easy to calculate and was proposed to predict in-hospital mortality. The Forrest classification is based on endoscopic findings and can be used to stratify patients into high- and low-risk categories in terms of rebleeding and thus is useful in predicting the need for endoscopic hemostasis. Early risk stratification is critical in the management of UGIB and may improve patient outcome and reduce unnecessary health care costs through standardization of care.

Keywords

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