ACURÁCIA DA ESCALA DE GLASGOW BLATCHFORD PARA IDENTIFICAÇÃO DE PACIENTES COM HEMORRAGIA DIGESTIVA ALTA DE BAIXO RISCO EM UM HOSPITAL PRIVADO DE FLORIANÓPOLIS
Palavras-chave:
Hemorragia. Transfusão Sanguínea. Mortalidade. Risco.Resumo
Introdução: As escalas mais utilizadas na prática clínica para avaliar a gravidade da hemorragia digestiva alta são a de Glasgow Blatchford e Rockall. No entanto, os estudos têm mostrado divergências quanto a capacidade de ambas predizeram o risco. Objetivo: Avaliar a acurácia para a identificação de pacientes de baixo risco com hemorragia ao comparar a escala de Glasgow Blatchford e Rockall. Métodos: Teste clínico realizado no Hospital Baia Sul, em Florianópolis-SC, com 84 pacientes com hemorragia digestiva alta entre 2011 e 2020. Os pacientes foram classificados, conforme as escalas de Rockall e Glasgow Blatchford (valor de corte 0 e 1) em baixo e alto risco para necessidade de transfusão sanguínea, ressangramento, óbito e internação em unidade de tratamento intensivo. Calculou-se sensibilidade, valor preditivo positivo e negativo, especificidade e área sob curva ROC (p<0,05) das escalas para cada fator de interesse e foram comparadas entre si. Resultados: Glasgow Blatchford foi melhor em predizer o risco de transfusão sanguínea (AUROC= 0,811 ± 0,092 contra 0,749 ± 0,104), equivalente para internação em unidade de tratamento intensivo (AUROC= 0,655 ± 0,120 contra 0,666 ± 0,116). Porém inferior a Rockall em ressangramento (AUROC=0,648 ± 0,115 contra 0,758 ± 0,111). Não houve significância estatística entre as escalas para óbito. Conclusão: Glasgow Blatchford mostrou-se eficaz para identificar os pacientes de baixo risco e superior em predizer o risco de transfusão sanguínea, sendo ponto de corte 1 o melhor.Referências
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