The effectiveness of Glasgow-Blatchford Score in early risk assessment of hemodialysis patients

Abstract

In the emergency departments (ED), the incidence of admission is increasing gradually due to gastrointestinal system (GIS) complications of hemodialysis (HD) patients. With this increasing number of patients, there are many classification systems developed in early risk assessment before endoscopy. In this study, we aimed to evaluate the Glasgow-Blatchford Score's (GBS) effectiveness in HD patients with suspected GIS hemorrhage in the ED.The files of 169 patients who received HD treatment were retrospectively reviewed. 64 patients who were examined and treated for reasons other than GIS hemorrhage in the ED were excluded, and the files of a total of 105 were analyzed retrospectively. The demographic characteristics and laboratory values of the patients were recorded from the patient files. When the patients were evaluated according to GBS parameters, a significant difference was found between the two groups in terms of pulse pressure, systolic blood pressure, hemoglobin value, melena, and accompanying comorbid diseases (p < 0.05). Of the 16 patients who presented to the ED due to syncope, 2 were in the GIS hemorrhage (+) group, and 14 patients were in the control group. In this study, we aimed to show that the increase in the number of admissions in the ED due to complications secondary to HD treatment and the accompanying serious changes in laboratory parameters may cause misleading results in patients with suspected GIS hemorrhage, and it is necessary to plan comprehensive and multi-center studies on new alternative scoring systems to GBS in specific patient groups such as HD patients.