Clinical scoring systems for determining the prognosis of gastrointestinal bleeding

Prognostic indicators of gastrointestinal (GI) bleeding offer the potential of substituting objective and scientific criteria for the current subjective and individualized criteria for decisions regarding the diagnosis and treatment of GI bleeding. Prognostic indicators could potentially provide criteria for decisions regarding hospitalization versus outpatient treatment, triage to a nonmonitored bed versus an intensive care unit, emergency versus elective endoscopy, timing of erythrocyte transfusions, diagnostic versus therapeutic endoscopy, diagnostic angiography, therapeutic angiography, emergency surgery, and early hospital discharge. Prognostic indicators may also help stratify patients according to disease severity for controlled studies and for comparison of results between studies. While early work focused on identification of individual independent prognostic indicators, recent work has focused on combining individual prognostic indicators to develop a multivariable prognostic scale.