Publication:

Upper gastro intestinal bleed: causes, endoscopic profile and usefulness of Rockall score in determining the outcome

Background Upper gastrointestinal hemorrhage is defined as any bleeding from a site in the gastrointestinal tract proximal to the ligament of Treitz (fore-gut). Patients with Upper gastrointestinal hemorrhage present with a wide range of clinical severity ranging from trivial bleeds to fulminant and lethal exsanguinations. It is associated with multiple risk factors and multiple co-morbid condition.

Methods A prospective cross-sectional study was conducted in a tertiary care hospital. A total of 56 patients who were subjected to endoscopy and were studied for 6 months. Appropriate statistical method had been applied wherever needed.

Results In the studied population among 56 patients, most common cause of UGIB was variceal bleed 45 (80%); most common of age group with variceal bleed belonged to 40-59 years, Grade III varices were most commonly found 23 (52%). The mean Rockall score was 4.7 which indicated that most patients belong to moderate risk group. The need of packed red blood cell transfusion and chances of rebleeding were more in high-risk group compared to low and moderate risk group. Patient mortality were only observed in high-risk group compared to low and moderate risk group.

Conclusions Upper GI endoscopy is beneficial in both diagnostic and therapeutic treatment of patients with UGIB. Rockall score helped in identifying that most of the patients belonged to moderate and high-risk group. Rockall score has been found to correlate well with clinical outcome, including need for transfusions, rebleeding and mortality, and may be used for effective triage of patients.