The Impact of Rockall Risk Scoring System on Management of Upper Gastrointestinal System Bleeding

• The necessity of emergency endoscopy. [ Time Frame: 1 month ] [ Designated as safety issue: No ]
  

• Morbidity [ Time Frame: 1 month ] [ Designated as safety issue: No ]
  
• Mortality [ Time Frame: 1 month ] [ Designated as safety issue: No ]
  
• Length of hospital stay [ Time Frame: 1 month ] [ Designated as safety issue: No ]
  

The patients who admit to emergency department with symptoms of upper gastrointestinal system bleeding will undergo a clinical evaluation. First, diagnosis of upper gastrointestinal system bleeding will be established by combined physical examination and nasogastric tube application. After a certain diagnosis, all of the patients will be scored according to Rockall Risk Scoring System. The patients with a 1 or less Rockall score will have conservative treatment including mucosal protective agent (sucralfat), proton pump inhibitors (omeprazole, lansoprazole, pantoprazole), and hemodynamic monitorization. Should Rockall score and hemodynamic parameters remain unchanged or get improved in the end of 6 hours after admission, oral feeding will be started and the patient will be discharged with anti-ulcer medication (mucosal protective agent and proton pump inhibitor, PO). These patients will be scheduled for upper gastrointestinal endoscopy at 30th day. The patients who have: an initial Rockall score of 2 or greater, an increase in Rockall score or deterioration in hemodynamic parameters during observation, will have emergency endoscopy and will be excluded from the study.