Abstract:

Aim: This study aimed to determine the most appropriate scoring system for the emergency department to facilitate the management of patients with gastrointestinal bleeding. Materials and Methods: Data were collected prospectively September’21-March’22 period in the emergency department. A total of 117 adult patients with GI bleeding were included. Composite clinical outcomes consisted of a need for surgical or endoscopic intervention, rebleeding, intensive care unit admission, or in-hospital mortality. Results: The median age of patients was 75 years and 58.1% (n=68) of them were male. Of the patients, 21 were hospitalized in the intensive care unit and 85 in the ward (17.94-72.64%). All three scoring systems can determine the hospitalization place or discharge of patients with GI bleeding. A positive and significant correlation was found between Glasgow-Blatchford and AIMS-65 and length of hospitalization (p<0.05). In-hospital mortality developed in 15 (12.82%) of the patients. Rockall, Glasgow-Blatchford, and AIMS-65 scoring systems were found to be significant for mortality prediction (AUC= 0.745 - 0.777 - 0.851). Seventy-one (60.68%) of patients received ES transfusion, and the Rockall, Glasgow-Blatchford, and AIMS-65 scoring systems were found to be significant for the prediction of ES transfusion (AUC= 0.624 - 0.826 - 0.653). Rebleeding developed in 16 (13.67%) patients. Glasgow-Blatchford and AIMS-65 scoring systems were found to be significant for rebleeding (p= 0.03-0.04). The Rockall classification was found to be insignificant (p=0.57). Conclusion: All scoring systems were successful in terms of management of patients with GI bleeding and survey estimation. The AIMS-65 scoring system stands out only in terms of rebleeding prediction. For this reason and it is more practical, we recommend the AIMS-65 scoring system for the emergency department.