Skip to main content
Erschienen in: Critical Care 3/2008

01.06.2008 | Commentary

Clinical risk stratification for gastrointestinal hemorrhage: still no consensus

verfasst von: Charles Wira, John Sather

Erschienen in: Critical Care | Ausgabe 3/2008

Einloggen, um Zugang zu erhalten

Abstract

A lack of consensus exists in the pre-endoscopic risk stratification of patients with upper or lower gastrointestinal hemorrhage. The work by Das and colleagues in the previous issue of Critical Care serves to externally validate the BLEED criteria. Their results suggest that hemodynamically stable patients without evidence of ongoing bleeding or unstable comorbidities may be at lower risk for hospital complications. While their results reinforce previous studies, further investigation is needed before comprehensive practice guidelines can be established.
Literatur
1.
Zurück zum Zitat Das AM, Sood N, Hodgin K, Chang L, Carson SS: Development of a triage protocol for patients presenting with gastrointestional hemorrhage: a prospective cohort study. Crit Care 2008, 12: R57. 10.1186/cc6278PubMedCentralCrossRefPubMed Das AM, Sood N, Hodgin K, Chang L, Carson SS: Development of a triage protocol for patients presenting with gastrointestional hemorrhage: a prospective cohort study. Crit Care 2008, 12: R57. 10.1186/cc6278PubMedCentralCrossRefPubMed
2.
Zurück zum Zitat Kollef MF, O'Brien JD, Zuckerman GR, Shannon W: BLEED: a classification tool to predict outcomes in patients with acute upper and lower gastrointestinal hemorrhage. Crit Care Med 1997, 25: 1125-1132. 10.1097/00003246-199707000-00011CrossRefPubMed Kollef MF, O'Brien JD, Zuckerman GR, Shannon W: BLEED: a classification tool to predict outcomes in patients with acute upper and lower gastrointestinal hemorrhage. Crit Care Med 1997, 25: 1125-1132. 10.1097/00003246-199707000-00011CrossRefPubMed
3.
Zurück zum Zitat Longstreth GF: Epidemiology of hospitalization for acute upper gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol 1995, 90: 206-210.PubMed Longstreth GF: Epidemiology of hospitalization for acute upper gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol 1995, 90: 206-210.PubMed
4.
Zurück zum Zitat Longstreth GF: Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol 1997, 92: 419-424.PubMed Longstreth GF: Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population-based study. Am J Gastroenterol 1997, 92: 419-424.PubMed
5.
Zurück zum Zitat Peura DA, Lanza FL, Gostout CJ, Foutch PG: The American College of Gastroenterology Bleeding Registry: preliminary findings. Am J Gastroenterol 1997, 92: 924-928.PubMed Peura DA, Lanza FL, Gostout CJ, Foutch PG: The American College of Gastroenterology Bleeding Registry: preliminary findings. Am J Gastroenterol 1997, 92: 924-928.PubMed
6.
Zurück zum Zitat Elmunzer BJ, Inadomie JM, Elta GH: Risk stratification in upper gastrointestional bleeding. J Clin Gastroenterol 2007, 41: 559-563. 10.1097/MCG.0b013e318030e930CrossRefPubMed Elmunzer BJ, Inadomie JM, Elta GH: Risk stratification in upper gastrointestional bleeding. J Clin Gastroenterol 2007, 41: 559-563. 10.1097/MCG.0b013e318030e930CrossRefPubMed
7.
Zurück zum Zitat Inayet N, Amoateng-Adjepong Y, Upadya A, Manthous CA: Risks for developing critical illness with GI hemorrhage. Chest 2000, 118: 473-478. 10.1378/chest.118.2.473CrossRefPubMed Inayet N, Amoateng-Adjepong Y, Upadya A, Manthous CA: Risks for developing critical illness with GI hemorrhage. Chest 2000, 118: 473-478. 10.1378/chest.118.2.473CrossRefPubMed
8.
Zurück zum Zitat Afessa B: Triage of patients with acute gastrointestinal bleeding for intensive care unit admission based on risk factors for poor outcome. J Clin Gastroenterol 2000, 30: 281-285. 10.1097/00004836-200004000-00015CrossRefPubMed Afessa B: Triage of patients with acute gastrointestinal bleeding for intensive care unit admission based on risk factors for poor outcome. J Clin Gastroenterol 2000, 30: 281-285. 10.1097/00004836-200004000-00015CrossRefPubMed
9.
Zurück zum Zitat Farrell RJ, Alsahli M, LaMont JT: Is successful triage of patients with upper-gastrointestional bleeding possible without endoscopy? Lancet 2000, 356: 1289-1290. 10.1016/S0140-6736(00)02808-7CrossRefPubMed Farrell RJ, Alsahli M, LaMont JT: Is successful triage of patients with upper-gastrointestional bleeding possible without endoscopy? Lancet 2000, 356: 1289-1290. 10.1016/S0140-6736(00)02808-7CrossRefPubMed
10.
Zurück zum Zitat Adamopoulos AB, Baibas NM, Efstathiou SP, Tsioulos DI, Mitromaras AG, Tsami AA, Mountokalakis TD: Differentiation between patients with acute upper gastrointestinal bleeding who need early urgent upper gastrointestinal endoscopy and those who do not. A prospective study. Eur J Gastroenterol Hepatol 2003, 15: 381-387. 10.1097/00042737-200304000-00008CrossRefPubMed Adamopoulos AB, Baibas NM, Efstathiou SP, Tsioulos DI, Mitromaras AG, Tsami AA, Mountokalakis TD: Differentiation between patients with acute upper gastrointestinal bleeding who need early urgent upper gastrointestinal endoscopy and those who do not. A prospective study. Eur J Gastroenterol Hepatol 2003, 15: 381-387. 10.1097/00042737-200304000-00008CrossRefPubMed
11.
Zurück zum Zitat Blatchford O, Murray WR, Blatchford M: A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet 2000, 356: 1318-1321. 10.1016/S0140-6736(00)02816-6CrossRefPubMed Blatchford O, Murray WR, Blatchford M: A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet 2000, 356: 1318-1321. 10.1016/S0140-6736(00)02816-6CrossRefPubMed
12.
Zurück zum Zitat Strate LL, Saltzman JR, Ookubo R, Mutinga ML, Syngal S: Validation of a clinical prediction rule for severe acute lower intestinal bleeding. Am J Gastroenterol 2005, 100: 821-827. 10.1111/j.1572-0241.2005.41755.xCrossRef Strate LL, Saltzman JR, Ookubo R, Mutinga ML, Syngal S: Validation of a clinical prediction rule for severe acute lower intestinal bleeding. Am J Gastroenterol 2005, 100: 821-827. 10.1111/j.1572-0241.2005.41755.xCrossRef
13.
Zurück zum Zitat Velayos FS, Williamson A, Sousa KH, Lung E, Bostrom A, Weber EJ, Ostroff JW, Terdiman JP: Early predictors of severe lower gastrointestinal bleeding and adverse outcomes: a prospective study. Clin Gastroenterol Hepatol 2004, 2: 485-490. 10.1016/S1542-3565(04)00167-3CrossRefPubMed Velayos FS, Williamson A, Sousa KH, Lung E, Bostrom A, Weber EJ, Ostroff JW, Terdiman JP: Early predictors of severe lower gastrointestinal bleeding and adverse outcomes: a prospective study. Clin Gastroenterol Hepatol 2004, 2: 485-490. 10.1016/S1542-3565(04)00167-3CrossRefPubMed
14.
Zurück zum Zitat Hoyt DB, Coimbra R: Trauma systems. Surg Clin N Am 2007, 87: 21-35. 10.1016/j.suc.2006.09.012CrossRefPubMed Hoyt DB, Coimbra R: Trauma systems. Surg Clin N Am 2007, 87: 21-35. 10.1016/j.suc.2006.09.012CrossRefPubMed
15.
Zurück zum Zitat Kaplan LJ, Kellum JA: Comparison of acid base models for prediction of mortality following trauma. Shock 2007, in press. Kaplan LJ, Kellum JA: Comparison of acid base models for prediction of mortality following trauma. Shock 2007, in press.
Metadaten
Titel
Clinical risk stratification for gastrointestinal hemorrhage: still no consensus
verfasst von
Charles Wira
John Sather
Publikationsdatum
01.06.2008
Verlag
BioMed Central
Erschienen in
Critical Care / Ausgabe 3/2008
Elektronische ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc6900

Weitere Artikel der Ausgabe 3/2008

Critical Care 3/2008 Zur Ausgabe

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.