Effectiveness of Blatchford and Rockall Scoring Systems to Predict Outcome of Immediate Medical Intervention in Patients with Upper Gastrointestinal Bleeding Referred to Emergency Department Download PDF

Background & Aim: The identification of high-risk patients with acute upper gastrointestinal bleeding (UGIB) is a real challenge facing emergency physicians in terms of the need for emergency endoscopy and urgent medical interventions. In this regard, the use of Rockall and Blatchford score systems can be helpful in meeting this challenge. As a result, this study was conducted to investigate the effectiveness of Blatchford and Rockall risk scoring systems in prediction of urgent medical intervention outcome in patients with upper gastrointestinal bleeding, referring to Shahid Beheshti hospital of Qom. Methods & Materials:: In this analytical retrospective study, a checklist derived from the Blatchford and Rockall risk scoring systems was used to collect data from medical records of 194 non-trauma UGIB patients, aged over 18 years old, visiting the Emergency Department of Shahid Beheshti Hospital between 2012-2015. The research samples were selected using the convenience sampling method. In the current study, the significance level was considered to be 0.05. In addition, the effectiveness of the Blatchford and Rockall risk scoring systems in predicting the urgent medical intervention outcome was investigated in SPSS and MEDCAL. Result: This study showed a significant relationship between the actual interventions administered to patients with UGIB in Shahid Beheshti Hospital and interventions predicted by the Blatchford risk scoring system (p=0.000, kappa=0.294). Moreover, a significant relationship was observed between the actual hospitalization unit in Shaid Beheshti Hospital with hospitalization unit predicted by the Rockall risk scoring system (p=0.000, kappa=0.182). On the other hand, no significant relationship was observed between the Blatchford risk scoring system and the age of participants (p=0.011). In contrast, a significant relationship was observed between the age of participants and the Rockall risk scoring system (p<0.00001). Conclusion: This study showed that the Blatchford risk scoring system can be used in the Emergency Department of Shahid Beheshti Hospital of Qom as a clinical guideline to determine the type of medical interventions (urgent or non-urgent). It also showed that the Rockall system can be used as a clinical guideline to determine the required level of medical interventions for a certain patient.