Gastrointestinal hemorrhage: Difference between revisions
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imported>Robert Badgett (New page: Gastrointestinal hemorrhage (GI bleeding) is defined as "bleeding in any segment of the gastrointestinal tract from esophagus to rectum."<ref>{{cite web |url=http://www.nlm.nih.gov/cgi...) |
imported>Robert Badgett m (Gastrointestinal Hemorrhage moved to Gastrointestinal hemorrhage: Oops of capitalization) |
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Revision as of 14:32, 9 November 2007
Gastrointestinal hemorrhage (GI bleeding) is defined as "bleeding in any segment of the gastrointestinal tract from esophagus to rectum."[1]
Prognosis
Upper gastrointestinal tract bleeding
For patients wtih nonvariceal upper gastrointestinal tract bleeding, the Blatchford score is a clinical prediction rule for predicting patients that will require blood transfusion, endoscopic or surgical management for bleeding control.[2]
The score is high risk if the patient has any of the following:
- Blood urea nitrogen ≥18.2 (mg/dL)
- Hemoglobin level
- for men <13 (g/dL)
- for women <12 (g/dL)
- Systolic blood pressure <109(mm Hg)
- Pulse rate ≥100 beats/min
- Melena
- Syncope
- Hepatic disease
- Heart failure
In a study in which 69.5% of the patients were had blood transfusion, endoscopic or surgical management, the accuracy fo the score is:
- sensitivity = 99.6%
- specificity = 25.0%
which yielded:
- positive predictive value = 75.2%
- negative predictive value = 96.4%
References
- ↑ National Library of Medicine. Gastrointestinal Hemorrhage. Retrieved on 2007-11-09.
- ↑ Chen IC, Hung MS, Chiu TF, Chen JC, Hsiao CT (2007). "Risk scoring systems to predict need for clinical intervention for patients with nonvariceal upper gastrointestinal tract bleeding". The American journal of emergency medicine 25 (7): 774–9. DOI:10.1016/j.ajem.2006.12.024. PMID 17870480. Research Blogging.