Management of acute nonvariceal upper gastrointestinal bleeding: Current policies and future perspectives

Table 1 Mortality rates in patients with upper gastrointestinal bleeding in various studies

	Czernichow et al[5]	Paspatis et al[4]	Van Leerdam et al[3]	Di Fiore et al[7]	Theocharis et al[1]	Hearnshaw et al[10]
Country	France	Greece	The Netherlands	France	Greece	United Kingdom
Year of publication	2000	2000	2003	2005	2008	2010
No. of patients	2133	353	769	453	353	6750
Mortality rate total (%)	14.3	5.6	13	7.2	6.5	7.4
Varices (%)	22.8	21.4	16	15.2	9	15
Peptic ulcer (%)	13.3	2.6	14	5	4.2	8.7

Table 2 Causes of upper gastrointestinal bleeding according to recent epidemiological studies[1,3-5,7,10]

	%
Peptic ulcer	31-67
Erosive	7-31
Variceal bleeding	4-20
Oesophagitis	3-12
Mallory-Weis	4-8
Neoplasm	2-8
Other	2-8
None	3-19

Table 3 Comparison of Blatchford and Rockall risk scoring systems

Risk factor	Blatchford score		Initial Rockall score
	Parameter	Score	Parameter	Score
Age (yr)	-		60-79	1
			≥ 80	2
Systolic blood pressure (SBP) (mmHg)	100-109	1	< 100	2
	90-99	2
	< 90	3
Heart rate (bpm)	> 100	1	> 100 with SBP ≥ 100	1
Clinical presentation	Melena	1	-
	Syncope	2
Comorbidity	Hepatic disease	2	CHF, IHD, major comorbidity	2
	Cardiac failure	2	Renal or liver failure, or disseminated cancer	3
Blood urea, mg/dL (mmol/L)	18.2-22.3 (6.5-7.9)	2	-
	22.4-27.9 (8-9.9)	3
	28-69.9 (10-24.9)	4
	≥ 70 (≥ 25)	6
Hemoglobin, g/dL (mmol/L)	F: 10-11.9 (6.2-7.4)	1	-
	M: 12-12.9 (7.5-8)
	M: 10-11.9 (6.2-7.4)	3
	F/M: < 10 (< 6.2)	6
			Complete Rockall score
Endoscopic diagnosis	-		Non-malignant, non-Mallory-Weis diagnosis	1
			Upper GI tract malignancy	2
Evidence of bleeding	-		Blood, adherent clot, active bleeding	2

M: Male; F: Female; CHF: Congestive heart failure; IHD: Ischemic heart disease.