Tammaro Leonardo, Di Paolo Maria-Carla, Zullo Angelo, Hassan Cesare, Morini Sergio, Caliendo Sebastiano, Pallotta Lorella
Gastroenterologia ed Endoscopia Digestiva, Ospedale Nuovo Regina Margherita, Via E. Morosini 300, Rome, Italy.
World J Gastroenterol. 2008 Aug 28;14(32):5046-50. doi: 10.3748/wjg.14.5046.
To investigate in a prospective study whether a simplified clinical score prior to endoscopy in upper gastrointestinal bleeding (UGIB) patients was able to predict endoscopic findings at urgent endoscopy.
All consecutive UGIB patients referred to a single endoscopic center during a 16 mo period were enrolled. Before endoscopy patients were stratified according to a simple clinical score (T-score), including T1 (high-risk), T2 (intermediate-risk) and T3 (low-risk). Endoscopy was performed in all cases within 2 h, and high-risk stigmata were considered for further analysis.
Out of the 436 patients included into the study, 126 (29%) resulted to be T1, 135 (31%) T2, and 175 (40%) T3. Overall, stigmata of recent haemorrhage (SRH) were detected in 118 cases (27%). SRH occurred more frequently in T1 patients than in T2/T3 cases (85% vs 3.2%; c2 = 304.5309, P < 0.001). Older age (t = 3.311; P < 0.01) and presence of comorbidities (c2 = 14.7458; P < 0.01) were more frequently detected in T1 than in T2/T3 patients.
Our simplified clinical score appeared to be associated with the detection of endoscopic findings which may deserve urgent endoscopy. A further, randomised study is needed to assess its accuracy in safely scheduling endoscopy in UGIB patients.
在一项前瞻性研究中调查上消化道出血（UGIB）患者内镜检查前的简化临床评分是否能够预测急诊内镜检查的结果。
纳入在16个月期间转诊至单一内镜中心的所有连续性UGIB患者。内镜检查前，根据简单临床评分（T评分）对患者进行分层，包括T1（高危）、T2（中危）和T3（低危）。所有病例均在2小时内进行内镜检查，并对高危征象进行进一步分析。
纳入研究的436例患者中，126例（29%）为T1，135例（31%）为T2，175例（40%）为T3。总体而言，118例（27%）检测到近期出血征象（SRH）。SRH在T1患者中比在T2/T3病例中更常见（85%对3.2%；c2 = 304.5309，P < 0.001）。T1患者比T2/T3患者更常出现老年（t = 3.311；P < 0.01）和合并症（c2 = 14.7458；P < 0.01）。
我们的简化临床评分似乎与可能需要急诊内镜检查的内镜检查结果相关。需要进一步的随机研究来评估其在安全安排UGIB患者内镜检查方面的准确性。
