Scoring systems for upper gastrointestinal bleeding: Which one scores better?

Excerpt

Scoring systems allow us to compartmentalize the myriad presentations, risk factors, and outcomes, into more or less uniform groups, so as to prioritize management and resource allocation. Multiple scoring systems abound in gastroenterology, often several for the same disorder. Their routine utilization in bedside management depends upon many factors, ease and practicality of use being the major one. While some like acute physiology and chronic health evaluation (APACHE), and model for end-stage liver disease (MELD) became rapidly integrated in clinical management, others are not routinely utilized despite strong recommendations from several societies and organizations. Scoring systems for upper gastrointestinal bleed (UGIB) fall into the latter category. A recent survey in the USA revealed that, of the 1402 emergency physicians, internists, and gastroenterologists surveyed, only 53% had ever heard of these, and 30% had ever used any scoring system [1]. While this is not an indictment of the scoring systems, it does convey the problem of cross-specialty awareness, and difficulty in remembering and recalling the parameters during an emergency. …