Development of a scoring system to predict mortality from upper gastrointestinal bleeding

D. Provenzale, R. S. Sandler, D. R. Wood, S. L. Levinson, J. T. Frakes, R. B. Sartor, A. L. Jackson, H. B. Kinard, E. H. Wagner, D. W. Powell

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Despite the widespread application of endoscopy in acute upper gastrointestinal bleeding, there is little evidence of improved survival among those who undergo the procedure. To select high-risk patients who might benefit most from diagnostic and therapeutic endoscopy, the authors developed and validated a scoring system based on prognostic indicators of increased mortality. The scoring system was developed from the best clinical predictors of mortality, determined in a prospective study of consecutive bleeding patients. The model was then tested in a prospective validation phase at three hospitals. Three main factors in the model predict mortality: (1) bleeding, including hematochezia, drop in hematocrit of 5%, short duration of bleeding, absence of melena, and hypotension; (2) liver disease, manifested by prolonged prothrombin time and encephalopathy; and (3) renal disease. Patients determined to be at high risk for death using the scoring system might be candidates for aggressive management and for therapeutic endoscopy.

Original languageEnglish (US)
Pages (from-to)26-32
Number of pages7
JournalAmerican Journal of the Medical Sciences
Volume294
Issue number1
StatePublished - 1987
Externally publishedYes

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Hemorrhage
Endoscopy
Mortality
Melena
Gastrointestinal Hemorrhage
Prothrombin Time
Brain Diseases
Hematocrit
Hypotension
Liver Diseases
Prospective Studies
Kidney
Survival
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Provenzale, D., Sandler, R. S., Wood, D. R., Levinson, S. L., Frakes, J. T., Sartor, R. B., ... Powell, D. W. (1987). Development of a scoring system to predict mortality from upper gastrointestinal bleeding. American Journal of the Medical Sciences, 294(1), 26-32.

Development of a scoring system to predict mortality from upper gastrointestinal bleeding. / Provenzale, D.; Sandler, R. S.; Wood, D. R.; Levinson, S. L.; Frakes, J. T.; Sartor, R. B.; Jackson, A. L.; Kinard, H. B.; Wagner, E. H.; Powell, D. W.

In: American Journal of the Medical Sciences, Vol. 294, No. 1, 1987, p. 26-32.

Research output: Contribution to journalArticle

Provenzale, D, Sandler, RS, Wood, DR, Levinson, SL, Frakes, JT, Sartor, RB, Jackson, AL, Kinard, HB, Wagner, EH & Powell, DW 1987, 'Development of a scoring system to predict mortality from upper gastrointestinal bleeding', American Journal of the Medical Sciences, vol. 294, no. 1, pp. 26-32.
Provenzale D, Sandler RS, Wood DR, Levinson SL, Frakes JT, Sartor RB et al. Development of a scoring system to predict mortality from upper gastrointestinal bleeding. American Journal of the Medical Sciences. 1987;294(1):26-32.
Provenzale, D. ; Sandler, R. S. ; Wood, D. R. ; Levinson, S. L. ; Frakes, J. T. ; Sartor, R. B. ; Jackson, A. L. ; Kinard, H. B. ; Wagner, E. H. ; Powell, D. W. / Development of a scoring system to predict mortality from upper gastrointestinal bleeding. In: American Journal of the Medical Sciences. 1987 ; Vol. 294, No. 1. pp. 26-32.
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