Escala UNAL de predicción para identificar pacientes con hemorragia digestiva alta que necesitan endoscopia urgente; UNAL of prediction climbs to identify patient … (original) (raw)
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Revista de la Sociedad Peruana de Medicina Interna, 2007
Objective. To develop a clinical prediction rule (CPR) for complicated upper gastrointestinal bleeding (UGB) and to compare it with Rockall score. Material and Methods. Patients with UGB admitted to the emergency unit of Hospital Nacional Hipólito Unanue, Lima, were included prospectively. We defined complicated UGB as the associated with dead, rebleeding or requirement of surgery. We included clinical and laboratory variables. A univariate and multivariate analysis were done based on a logistic regression model. The final model was subsequently simplified through a linear transformation. The area under the curve (AUC) of the score was compared with the AUC of Rockall score before and after endoscopy. Results. Ninety eight patients were included between January 2005 and June 2006. Mortality was 9,1% and the proportion of patients with complicated UGB was 27,5%. The scoring system developed was as follow: Probability of complicated UGB = Age (in years)/2 + 30 (if jaundice present) + 25 (if thrombocytopenia)-8. The AUC ROC was 0,78 (IC 95% 0,67-0,88) while it was 0,73 (IC 95% 0,61-0,86) for the pre-endoscopic Rockall score and 0,81 (IC 95% 0,70-0,92) for the post-endoscopic Rockall score. Conclusions. The scoring system developed represents a useful, affordable and easily applicable tool for the initial evaluation of the patient with upper digestive bleeding and is comparable with the Rockall score.
Valor de la Escala de Rockall en la predicción de la mortalidad de la Hemorragia digestiva alta
2018
Introduction: Upper gastrointestinal bleeding (UGB) has a worldwide incidence between 50 and 140 patients for every 100 000 inhabitants a year; the mortality varies from a country to another, but during the last decades in Cuba, it fluctuates between 4 and 10% in those of non-varicose origin and reaches 30% in cases associated with portal hypertension. Objective: To evaluate the utility of the Rockall score in the risk stratification for mortality in patients with upper gastrointestinal bleeding. Material and Methods: A longitudinal prospective study was conducted in patients that came to “Dr. Carlos J. Finlay” Central Military Hospital with the diagnosis of upper gastrointestinal bleeding from November 2012 to March 2016, to whom the Rockall score was applied to determine its predictive capacity of estimating mortality . Results: 394 patients were studied; 48 of them died (12,19%). When stratifying the patients in risk groups according to Rockall score it was found that the greates...
Utilidad de la escala clínica de Rockall en la hemorragia digestiva alta no varicosa
Revista Cubana De Cirugia, 2014
Introducción: la escala clínica de Rockall se utliza para clasificar la hemorragia digestiva alta en individuos atendiendo al riesgo de presentar sangrado activo, que necesiten de la realización urgente de la endoscopia digestiva. Objetivo: evaluar, la eficacia de la escala clínica de Rockall para identificar a los pacientes que requieren terapéutica endoscópica. Métodos: se realizó un estudio prospectivo. Se calculó el índice clínico de Rockall según escala homónima. Se realizó endoscopia de urgencia y terapéutica hemostática a pacientes con sangrado activo o reciente. La eficacia de este proceder se determinó mediante el análisis por curva de escala clínica de Rockall, índice de Youden y cálculo de sensibilidad y especificidad del mejor punto de corte. Resultados: incluidos 118 pacientes, 22 de los cuales (18,6 %) recibieron terapéutica endoscópica por presentar sangrado activo o reciente. Índice clínico de Rockall con una media de 1,79 puntos. Riesgo alto 83 pacientes (70,3 %) y bajo 35 casos (29,7 %). La capacidad predictiva excelente, con valor del área bajo la curva = 0,960 (IC 95 %: 0,904-1,017); punto de corte igual a 1 (índice de Youden = 0,971) con una sensibilidad de 97 % y de especificidad de 71 %.
Factores pronósticos de muerte en pacientes con hemorragia digestiva alta
2017
Introduction: the upper digestive bleeding is the blood escape to the lumen of the digestive tube, between the upper esophagus and the Treitz angle. It is a common cause of consultation and hospitalization in the Emergency Services.Objective: to identify the prognostic factors of death in patients with upper gastrointestinal bleeding. Method: it was performed a cohort study in patients with a diagnosis of upper gastrointestinal bleeding, who were hospitalized in the service of General surgery at "Carlos Manuel de Céspedes" Provincial University Hospital in Bayamo, since May 1, 2008 until May 31, 2009. Results: the logistic regression model showed that severe bleeding (OR 17.704, 95% CI 7,653- 33.089) followed by hypovolemic shock (OR: 9.428, 95% CI 1.784 to 29.539) and heart failure (OR 5,604 CI 95% 2,539- 32.085) evidenced an independent, statistically significant relationship with the risk of dying. Conclusions: it can be said that with the values obtained by adjusting ...
Methodo. Investigación Aplicada a las Ciencias Biológicas, 2017
La hemorragia digestiva alta (HDA) es una urgencia frecuente. La evaluación inicial con escalas pronósticas pre y postendoscópicases fundamental para conocer los pacientes con mayor riesgo de complicaciones y con ello decidir la realización de una intervención de urgencia.2-5Hipótesis:Las escalas pronósticas pre y postendoscópicas validadas para HDA no variceal predicen mortalidad, resangrado y necesidad de intervención en nuestra población de pacientes.Objetivos. Primarios. Evaluar la correlación de las escalas pronósticas preendoscópicas Blatchford y Rockall y las post endoscópicas Forrest y Rockall con mortalidad, resangrado y necesidad de intervención intrahospitalaria en HDA no variceal. Evaluar la concordancia entre los resultados de las escalas pre y postendoscópicas. Secundarios.Describir las causas más frecuentes y la mortalidad de HDA no variceal.
Caracterización del paciente anciano con hemorragia digestiva alta
2009
A descriptive, observational and cross-sectional study of 40 elderly patients with upper digestive hemorrhage, admitted at the Service of General Surgery of "Dr. Ambrosio Grillo Portuondo" Teaching Clinical-Surgical Hospital from Santiago de Cuba during the 2007 was carried out, in order to characterize them by means of a series of variables related to this diagnosis. The primary data were obtained from the corresponding medical records. Among the main results there were: the male sex, the age group from 60 to 69 years, the associated cardiovascular diseases, the alcohol and coffee intake as toxic habits and the use of anti-inflammatory and non-steroid medications and aspirin as ulcerogenic drug. The diagnosis was reached by means of the barium contrast x-ray and the gastroduodenal ulcer was the most frequent cause; the medical treatment was the most used and most of the patients were discharged between 1 and 7 days after their hospitalization. Subject headings GASTROINTES...