ROCK ALL SCORE IN NONVARICEAL UPPER GASTROINTESTINAL BLEEDING (NVUGIB): A PREDICTOR OF IN - HOSPITAL REBLEEDING

Introduction : Although the Rockall scoring system is designed to predict morbidity, mortality and bleeding in patients, the accuracy and validity of these indicators had not been reviewed among the patients of the north of Iran, Guilan. The aim of this study was to evaluate the Rockall scoring system among p rimary nonvariceal upper gastrointestinal bleeding (NVUGIB) patients in Guilan province, north of Iran. Materials and Methods: This cross - sectional study was performed in 197 patients with primary nonvariceal manifestation of upper gastrointestinal bleedin g at a reference educational hospital. All patients underwent endoscopy within 12 hours of presentation of symptoms. After demographic data, endoscopic findings and history of gastrointestinal diseases registrations, Rockall scores were calculated. Also, t he patients were divided into three groups: (1) low risk, (2) intermediate risk and (3) high risk. Results: Twenty - seven of the patients were classified as high risk (21 males and 6 females). Eleven of them were aged 80 years old and 6 cases were older. Th e number of cases with the history of alcohol consumption and smoking were 3 and 7, respectively. Previous gastrointestinal bleeding history and previous endoscopy history were observed among 4 subjects in two different groups. Six of eight patients with r ebleeding were considered as high risk group. The mean Rockall score among patients with and without rebleeding were 2.9±1.7 and 6±1.8, respectively (P= 0.02). Validation of Rockall score showed accuracy of 0.995 with 95% confidence between 0.983 - 1.000. Hi gh risk group patients, with Rockall scores greater than 6, had the possibility of rebleeding with the sensitivity of 100% and the specificity of 93.3%. Conclusion: According to the results of this study, the Rochall score was effective in rebleeding predi ction. Therefore, we recommend the use of this score in emergency departments for patients in order to additional monitoring and treatment for prevention of rebleeding in hospital.