Original ArticleValidity of the Rockall scoring system after endoscopic therapy for bleeding peptic ulcer: a prospective cohort study
Section snippets
Patients and methods
Between November 1996 and January 2001, 247 patients with a bleeding peptic ulcer were recruited to a randomized, controlled trial that compared endoscopic therapy with a heat probe plus human thrombin injection and endoscopic therapy with a heat probe plus placebo injection. The results of the study have been published.11 All patients presented with significant upper-GI hemorrhage and at least one of the following clinical risk factors: age over 60 years, Hb less than 10 g/dL, the presence of
Results
The Rockall scores for all 247 patients in the trial followed a fairly symmetrical distribution (Fig. 1).
The mean score for the entire sample was 5.8. Because all patients had peptic ulcer disease with active bleeding or stigmata of recent hemorrhage, the minimum Rockall score was 3. Thirty-six patients (15%) had recurrent bleeding within 30 days of endoscopic therapy, and 22 (9%) died. The outcome in relation to Rockall score is shown in Table 2. There was a significant relationship between
Discussion
The Rockall scoring system was developed from an analysis of data obtained from a large audit of patients who presented with upper-GI bleeding because of a wide range of causes, and only a minority of patients received endoscopic therapy. The current analysis was designed to determine whether the Rockall system is applicable to the subset of patients with high-risk ulcer bleeding who require endoscopic hemostatic therapy. It also was desirable to identify a cutoff point below which patients
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This study and N. I. Church's salary were supported by a grant from the Scottish National Blood Transfusion Service.
See CME section; p. 676.