Clinical trial NCT06254352: Clinical Risk Scores in Prediction Outcome of Acute UGIT Bleeding in Non Cirrhotic Patients
Official title: Evaluation of Clinical Risk Scores in Prediction of Outcome of Acute Upper Gastrointestinal Bleeding in Non Cirrhotic Patients
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Upper GI Bleeding
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2024-02-12
Enrollment: 100
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: All patients within the current study will be subjected to:

I-Complete medical history. II-Through clinical examination. III-Laboratory investigations including Complete blood count (CBC) Liver profile (serum bilirubin, serum albumin, PT and INR) Blood urea and creatinine

IV-Abdominal Ultrasonography :

VI-Risk scoring systems :

At the time of admission, each of following 4 scores will be calculated and recorded (Glasgow Blatchford score, MAP score, H3B2 score and ABC score to validate outcome in the studied patients The Glasgow-Blatchford score "GBS" (6) MAP score, (11) The ABC score: (10) H3B2 score (12)

V-Upper GIT endoscopy :

Brief summary: To compare the ability of 4 bleeding risk scoring systems (Glasgow -Blatchford score, MAP, H3B2 and ABC scores ) in prediction of: Need of intervention, Re bleeding, Thirty-day mortality, length of hospital stay

Detailed description: Acute upper gastrointestinal bleeding (UGIB) is a common medical emergency which has a variceal and non-variceal etiology. The non variceal etiology has higher incidence in many countries. In Egypt, non-variceal causes ranged from 26.1% to 61.6% among UGIB cases presented to the emergency departments of different University Hospitals. Guidelines recommend risk stratification early in the management of patients with acute UGIB to help triage patients into the appropriate level of care. Many scoring systems for UGIB were developed and validated from 1990s onwards. Their primary aim was to segregate the patients into low-risk and high-risk groups. High risk patients with UGIB includes those who reach some or all of the endpoints: requirement of blood transfusion, endo-therapeutic, surgical or radiological intervention to achieve hemostasis, re bleeding and mortality. Unfortunately, no single risk score has been shown to be accurate at measuring all relevant outcomes.

The most widely used score is Glasgow Blatchford "GBS" which is a pre endoscopic score. It is useful in prediction of therapeutic intervention for bleeding. More recently, other scores have been developed as ABC score which showed good performance for predicting mortality. MAP score highly predicted therapeutic intervention and mortality. H3B2 score predicted the need of urgent hemostasis.

Limited data are available on the validity of the new scoring systems in predicting the outcome of Egyptian non-cirrhotic patients with acute UGIB. Therefore, The investigators will conduct our study to shed some light on this topic.

Eligibility criteria: Inclusion Criteria:

* Adult non cirrhotic patients
* patients more than 18 years old
* Hematemesis or coffee grounds vomiting.
* Melena with or without hematemesis.
* Blood in nasogastric tube in emergency unit.

Exclusion Criteria:

* Patients younger than 18 years old.
* Patients known to be cirrhotic.
* Patients presented with GIT bleeding but refuse to be examined by GIT endoscopy.

Primary outcomes:
measure: correlation between Glasgow -Blatchford score, MAP score.
timeFrame: Baseline
measure: correlation between Glasgow -Blatchford score, H3B2 score.
timeFrame: Baseline
measure: correlation between Glasgow -Blatchford score, ABC score.
timeFrame: Baseline
measure: correlation between MAP score, H3B2 score.
timeFrame: Baseline
measure: correlation between MAP score, ABC score.
timeFrame: Baseline
measure: correlation between H3B2 score, ABC score.
timeFrame: Baseline
Secondary outcomes:
Other outcomes:
Locations:
Study officials:
References:
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