Effectiveness of an upper-gastrointestinal haemorrhage unit: a prospective analysis of 900 consecutive cases using the Rockall score as a method of risk standardisation

被引:45
作者
Sanders, DS
Perry, MJ
Jones, SGW
McFarlane, E
Johnson, AG
Gleeson, DC
Lobo, AJ
机构
[1] Univ Sheffield, Royal Hallamshire Hosp, Gastroenterol & Liver Unit, Sheffield S10 2JF, S Yorkshire, England
[2] Univ Sheffield, Royal Hallamshire Hosp, Dept Surg, Sheffield S10 2JF, S Yorkshire, England
关键词
upper-gastrointestinal haemorrhage; Rockall score;
D O I
10.1097/00042737-200405000-00009
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objectives To assess the effectiveness of a centralised upper-gastrointestinal haemorrhage (UGIH) unit. Methods The UK Audit of acute UGIH resulted in the formulation of a simple numerical scoring system, The Rockall score categorises patients by risk factors for death and allows case-mix comparisons. A total of 900 consecutive patients admitted to a UGIH unit between October 1995 and July 1998 were analysed prospectively. Patients were given an initial Rockall score and, if endoscopy was performed, a complete score. This method of risk stratification allowed the proportion of deaths (in our study) to be compared with the National Audit using risk standardised mortality ratios. Results The distribution of both initial and final Rockall scores was significantly higher in our study than in the National Audit A total of 73 (8.1 %) patients died, compared with the National Audit mortality of 14%. Risk-standardised mortality ratios using both initial and complete Rockall scores were significantly lower in our study when compared with those in the National Audit. Conclusion A specialised UGIIH unit is associated with a lower proportion of deaths from UGIH, despite comprising a greater number of high-risk patients than the National Audit. This lower mortality therefore cannot be attributed to a more favourable case mix and demonstrates that further improvements in mortality for UGIH can be made. Eur J Gastroenterol Hepatol 16:487-494 (C) 2004 Lippincott Williams Wilkins.
引用
收藏
页码:487 / 494
页数:8
相关论文
共 43 条
  • [1] Altman DG, 1990, PRACTICAL STAT MED R
  • [2] [Anonymous], 1975, J R Coll Physicians Lond, V10, P5
  • [3] Acute upper gastrointestinal haemorrhage in west of Scotland: case ascertainment study
    Blatchford, O
    Davidson, LA
    Murray, WR
    Blatchford, M
    Pell, J
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 1997, 315 (7107): : 510 - 514
  • [4] A risk score to predict need for treatment for upper-gastrointestinal haemorrhage
    Blatchford, O
    Murray, WR
    Blatchford, M
    [J]. LANCET, 2000, 356 (9238) : 1318 - 1321
  • [5] Scoring systems and risk assessment for upper gastrointestinal bleeding
    Ch'ng, CL
    Kingham, JGC
    [J]. EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 2001, 13 (10) : 1137 - 1139
  • [6] CHAPMAN BL, 1979, BRIT HEART J, V42, P386, DOI 10.1136/hrt.42.4.386
  • [7] Chung SC, 2001, AM J GASTROENTEROL, V96, P1
  • [8] Relevance of the Rockall score in patients undergoing endoscopic therapy for peptic ulcer haemorrhage
    Church, NI
    Palmer, KR
    [J]. EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 2001, 13 (10) : 1149 - 1152
  • [9] CLEMENTS D, 1991, J ROY COLL PHYS LOND, V25, P27
  • [10] COLLINS R, 1995, NEW ENGL J MED, V345, P108