Acute upper gastrointestinal bleeding risk stratification using Rockall scoring system

Abstract EN

Objective : The Rockall risk scoring system uses clinical criteria and endoscopy to identify patients at risk of adverse outcomes after acute upper gastrointestinal haemorhage.

The aim of this study was to identify patients at risk of adverse outcome following acute upper gastrointestinal bleeding.

Methods : An observational descriptive hospitalbased study conducted in Al-Yarmouk Teaching Hospital in Baghdad on 65 patients with acute upper gastrointestinal bleeding from July 2015 through December 2015.

Data from history, physical examination and endoscopies were performed to confirm the diagnosis within 24-48 hours after admission, and the complete Rockall score was calculated.

A Rockall score >2 was used to define ‘high risk’.

Results: Of the 65 patients, 43 were males, 22 were females, mean age was 50.1, nine patients were having hypotension (systolic blood pressure below 100 mm.Hg) at percentage of 13.8%.

Twenty-five patients were having tachycardia (pulse rate 100 per min and above) at percentage of 38.5%.

Seventeen patients having diabetes mellitus and another 17 were having hypertension.

Four patients were having peptic ulcer disease, chronic kidney disease (CKD) and chronic liver disease.

The most commen cause of acute upper (GIT) bleeding was peptic ulcer (PU) in 21 patients (32.3%).

Patients considered to be at low risk of adverse outcomes were 25 (38%), while patients considered to be at high risk of adverse outcome were 40 (62%).

Conclusions : The majority of the patients who were admitted to hospital with upper gastrointestinal bleeding were of high risk group and of male gender.

So we think that the application of the complete Rockall score are useful for Iraqi patients who present with acute upper gastrointestinal tract bleeding, especially for the elderly, those with comorbidities, and presence of significant endoscopic finding.