Please use this identifier to cite or link to this item: https://doi.org/10.1155/2017/3171697
Title: Clinical Performance of Prediction Rules and Nasogastric Lavage for the Evaluation of Upper Gastrointestinal Bleeding: A Retrospective Observational Study
Authors: Dakik, H.K
Srygley, F.D
Chiu, S.-T
Chow, S.-C 
Fisher, D.A
Keywords: adult
Article
clinical evaluation
cohort analysis
diagnostic accuracy
electronic medical record
emergency ward
female
gastroenterological procedure
gastrointestinal endoscopy
Glasgow Blatchford Score
human
ICD-9
major clinical study
male
medical record review
nasogastric lavage
observational study
outcome assessment
predictive value
retrospective study
scoring system
sensitivity and specificity
upper gastrointestinal bleeding
Issue Date: 2017
Citation: Dakik, H.K, Srygley, F.D, Chiu, S.-T, Chow, S.-C, Fisher, D.A (2017). Clinical Performance of Prediction Rules and Nasogastric Lavage for the Evaluation of Upper Gastrointestinal Bleeding: A Retrospective Observational Study. Gastroenterology Research and Practice 2017 : 3171697. ScholarBank@NUS Repository. https://doi.org/10.1155/2017/3171697
Rights: Attribution 4.0 International
Abstract: Introduction. The majority of patients with acute upper gastrointestinal bleeding (UGIB) are admitted for urgent endoscopy as it can be difficult to determine who can be safely managed as an outpatient. Our objective was to compare four clinical prediction scoring systems: Glasgow Blatchford Score (GBS) and Clinical Rockall, Adamopoulos, and Tammaro scores in a sample of patients presenting to the emergency department of a large US academic center. Methods. We performed a retrospective cohort study of patients during 2008-2010. Our outcome was significant UGIB defined as high-risk stigmata on endoscopy, or receipt of blood transfusion or surgery, or death. Results. A total of 393 patients met inclusion criteria. The GBS was the most sensitive for detecting significant UGIB at 98.30% and had the highest negative predictive value (90.00%). Adding nasogastric lavage data to the GBS increased the sensitivity to 99.57%. Conclusions. Of all four scoring systems compared, the GBS demonstrated the highest sensitivity and negative predictive value for identifying a patient with a significant UGIB. Therefore, patients with a 0 score can be safely managed as an outpatient. Our results also suggest that performing a nasogastric lavage adds little to the diagnosis UGIB. © 2017 Hassan K. Dakik et al.
Source Title: Gastroenterology Research and Practice
URI: https://scholarbank.nus.edu.sg/handle/10635/179889
ISSN: 16876121
DOI: 10.1155/2017/3171697
Rights: Attribution 4.0 International
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