Comparative Study on Prediction of Clinical Outcome of the Patients Presenting with Upper Gastrointestinal Bleeding Using Glasgow-Blatchford Score and Full Rockall Score Systems in Tertiary Care Center
Introduction and Objectives: Upper gastrointestinal bleeding (UGIB) is a potential life-threatening bleeding condition requiring accurate, prompt, and appropriate patient evaluation management. Early resuscitation and surgical intervention play a vital role in deciding the mortality and morbidity. Considerable advances have been made in endoscopic, surgical, and pharmacological therapy. The present study is aimed at the prediction of clinical outcome of the patients presenting to with UGIB using full Rockall score (RS) and the Glasgow-Blatchford score (GBS) systems. Materials and Methods: This was a prospective study where 118 patients who presented to the casualty with UGIB were studied. The data regarding the clinical profile, comorbidities, and course in the hospital were recorded. The GBS and full RS systems were calculated for every patient. The clinical course and outcome of each patient during the hospital stay were recorded. The patients were followed up for 1 month post-discharge for the complications such as rebleeding and mortality. Results: Follow-up was not done in 27 patients due to poor compliance. 11 patients had rebleeding (rebleeding rate - 12%) and 15 patients succumbed to the illness (mortality rate -16.5%) during 1-month follow-up period. During our study, it was found that GBS was more accurate in terms of detecting transfusion need, rebleeding rate, intensive care unit admission rate, and endoscopic intervention rate. Our study concluded that full RS was better than GBS in the prediction of 1-month mortality rate. Conclusion: The present study found that full RS system is better for the prediction of 1-month mortality, while GBS system is better for the prediction of other outcomes. Familiarity with the above scoring system can be a tool in the approach of the patient with UGIB.