Armenteros TMC, Palomino BAB, Valladares RD, Blanco AM, Muller ME

Language: Spanish
References: 19
Page: 312-320
PDF size: 210.23 Kb.

ABSTRACT

Introduction: Reducing mortality in patients with upper gastrointestinal bleeding is due not only to endoscopic therapy but also to clinical care, including volume replacement and blood transfusion if required. So it is necessary to evaluate the utility of prognostic parameters on the stratification of the risk of need for blood transfusion.
Objective: Evaluate the utility of Rockall index on the stratification of the risk of need for blood transfusion in patients with upper gastrointestinal bleeding episode of non varicosa origin.
Methods: A longitudinal, descriptive and prospective study was carried out from December 2011 to June 2012. Patients admitted to the hospital emergency room, with clinical evidence of upper gastrointestinal bleeding, who underwent an endoscopy within 24 hours after admission. Clinical parameters (age, comorbidity, and hemodynamic status), endoscopic (findings, stigmata of bleeding) and need for blood transfusion were assessed. Transfused patients and different variables included in the Rockall index were listed to determine risk factors when transfusion need.
Results: 89 patients were studied with a predominance of males (n= 64, 71.91 %), mean age 63, 58 years. Comorbidity, hemodynamic state and the presence of stigmata of active or recent bleeding (RR= 8.31 IC: 0.73-1.27; RR= 2.43 IC: 0.22- 1.78 y RR= 5.05 IC: 0.62-1.38 respectively. p=0.00) were identified as risk factors for transfusion need. 26 % of cases (n= 23) had a high index Rockall. This index had predictive poor capacity of transfusion need (area under the ROC curve of 0.682; p= 0.020).
Conclusion: Rockall index was useful to identify patients at increased risk of transfusion need, it can be used for the adequate selection of patients with nonvaricosa gastrointestinal bleeding that need transfusional therapy.

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