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ISSN 1561-3046 (Electronic)

2015, Number 2

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Rev Cub Med Mil 2015; 44 (2)

Modified Blatchford Scale for non-variceal upper gastrointestinal bleeding

Infante VM, Roselló OR, Ramos CJY, Rodríguez ÁD, Guisado RY, García VME

Language: Spanish
References: 17
Page: 179-186
PDF size: 127.25 Kb.


ABSTRACT

Introduction: prognostic scales have a wide use in the diagnosis, treatment and monitoring patients with non-variceal upper gastrointestinal bleeding.
Objective: determine the predictive ability of clinical component elements of Blatchford modified scale to identify patients most likely to have stigmata of active or recent bleeding during emergency endoscopy.
Methods: observational, analytical and prospective study. All patients were included, 188, assisted in the emergency unit at "Dr. Luis Díaz Soto" Central Military Hospital, from January 1 to December 31, 2012. An estimate risk for each scale components was performed. The predictive value using ROC curve was calculated. The sensitivity and specificity of cut off 1 was determined.
Results: 61 (32.4 %) out of the patients studied had scars of active or recent bleeding. Stigmas are more likely found in cases with systolic blood pressure ≤ 90 mmHg (RR 7.53; 95 % CI 2.31 to 24.48; p= 0.001), heart rate ≥ 100 beats min (RR 5.49; 95 % CI 2.78 to 10.83; p= 0.001) and hemoglobin ≤ 10 g/dL (RR 4.39; 95% CI 2.17 to 8.89; p = 0.001). The predictive capacity of Blatchford scale was good (c= 0.729; 95 % CI: 0.652 to 0.807; p= .001). The cut point 1 showed a sensitivity of 11.81 % and a specificity of 98.36 %.
Conclusions: the value of the Blatchford scale is confirmed abbreviated to predict the presence of stigmata of active or recent bleeding during endoscopic study in patients with non-variceal upper gastrointestinal bleeding.


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