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2014, Number 3

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Revista Cubana de Cirugía 2014; 53 (3)

Usefulness of Rockall clinical score in upper non variceal gastrointestinal bleeding

Infante VM, Guisado RY, Rodríguez ÁD, Ramos CJY, Angulo PO, Domínguez OR

Language: Spanish
References: 22
Page: 235-243
PDF size: 205.62 Kb.


ABSTRACT

Introduction: the clinical Rockall score serves to stratify the individuals with non variceal upper gastrointestinal hemorrhage depending on the risk of presenting active bleeding and therefore, they urgently need digestive endoscopy.
Objective: to evaluate the effectiveness of the Rockwall clinical score in identifying patients who need therapeutic endoscopy.
Methods: a prospective study with calculation of the Rockall clinical score according to a homonymous scale. Performance of urgent endoscopy and of therapeutic hemostatic endoscopy in patients with active or recent bleeding. Determination of efficacy through the analysis of ROC curves, Youden´s index and calculation of sensibility and specificity of the best cutoff point.
Results: one hundred and eighteen patients were included, 22 of whom (18.6 %) received therapeutic endoscopy to manage active or recent bleeding. Rocwall clinical score reached a mean of 1.79 points. It was found that 83 (70.3 %) were high and 35 (29.7 %) low risk patients. The predictive capacity was excellent, being the ABC= 0.960 (95 % CI: 0,904-1,017). The cutoff point was 1 (J= 0.971) with 97 % sensibility and 71 % specificity.
Conclusions: the Rockall clinical score can be safely used to make a decision on the urgent performance of endoscopy in patients with non-variceal upper gastrointestinal bleeding.


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