The Impact of Rockall Risk Scoring System on Management of Upper Gastrointestinal System Bleeding

Study Overview
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Brief Summary
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The patients who admit to emergency department with upper gastrointestinal system bleeding will undergo a clinical evaluation with Rockall Risk Scoring System. The patients with Rockall score of 1 or less will be discharged with medical treatment, and will have an elective upper gastrointestinal endoscopy in the end of the 30th day. The impact of Rockall Risk Scoring System on assessing the necessity of emergency endoscopy, length of hospital stay, morbidity, and mortality in low-risk patients will be evaluated.

Detailed Description
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The patients who admit to emergency department with symptoms of upper gastrointestinal system bleeding will undergo a clinical evaluation. First, diagnosis of upper gastrointestinal system bleeding will be established by combined physical examination and nasogastric tube application. After a certain diagnosis, all of the patients will be scored according to Rockall Risk Scoring System. The patients with a 1 or less Rockall score will have conservative treatment including mucosal protective agent (sucralfat), proton pump inhibitors (omeprazole, lansoprazole, pantoprazole), and hemodynamic monitorization. Should Rockall score and hemodynamic parameters remain unchanged or get improved in the end of 6 hours after admission, oral feeding will be started and the patient will be discharged with anti-ulcer medication (mucosal protective agent and proton pump inhibitor, PO). These patients will be scheduled for upper gastrointestinal endoscopy at 30th day. The patients who have: an initial Rockall score of 2 or greater, an increase in Rockall score or deterioration in hemodynamic parameters during observation, will have emergency endoscopy and will be excluded from the study.

Official Title
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The Impact of Rockall Risk Scoring System on Timing of Endoscopy, Length of Hospital Stay, Morbidity and Mortality in Patients With Upper Gastrointestinal System Bleeding

Conditions
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Gastrointestinal Hemorrhage

Intervention / Treatment
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* Procedure: Gastroscopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical diagnosis of upper gastrointestinal system bleeding Rockall score of 1 or less Volunteers Agreement with the terms of informed consent Exclusion Criteria: Uncertain clinical diagnosis of upper gastrointestinal system bleeding Rockall score of 2 or greater Deterioration in hemodynamic parameters during follow-up Unwilling patients to join the study Disagreement with the terms of informed consent

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Go-home group<br>The patients with a Rockall score of 0 or 1 will be prescribed medical therapy, and will be scheduled for elective gastroscopy. | Procedure: Gastroscopy<br>* Gastroscopy<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The necessity of emergency endoscopy. |  | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Morbidity |  | 1 month | 
| Mortality |  | 1 month | 
| Length of hospital stay |  | 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Gastrointestinal bleeding, Emergency endoscopy, Rockall Risk Scoring System