T-score Assessment in Patients with Upper Gastrointestinal Bleeding

Backgrounds: Upper gastrointestinal hemorrhage, a major cause of morbidity and mortality, particularly in the elderly, presents with diverse causes such as peptic ulcers, varices, and rare conditions. Urgent upper gastrointestinal endoscopy within the first 24 h is crucial for diagnosis and treatment but is not universally feasible. The total (T-score) clinical score is being evaluated as a triaging tool to identify patients requiring urgent endoscopy. Objectives: This study aims to assess the utility of the simplified clinical score (T-score) in categorizing patients needing urgent endoscopy for upper gastrointestinal bleeding. Materials and Methods: In a prospective study involving 53 patients, the T-score was calculated based on systolic blood pressure, hemoglobin, pulse, and co-morbidity. Patients were categorized into severity groups, and urgent upper endoscopy within 24 h correlated T-score groups with the presence of stigmata of recent hemorrhage, considering various factors. Results: Statistical analysis revealed significant correlations between T-score groups and the presence of stigmata of recent hemorrhage, systolic blood pressure, co-morbidity, hemoglobin level, and pulse rate. High-risk patients were mainly aged >65 years, with peptic ulcers, gastric ulcers, and other causes identified as common culprits. Conclusion: Pre-endoscopy clinical classification using the T-score system is beneficial for predicting patient groups likely to benefit from urgent endoscopy. This approach facilitates early discharge for patients with mild bleeding.