• Paolo Quitadamo, Federica Anselmi, Cecilia Mantegazza, Renato Tambucci, Angelo Campanozzi, Monica Malamisura, Umberto Raucci, Vincenzo Tipo, Pasquale Dolce, Marco Deganello Saccomani, Andrea Chiaro, Valentina Mancini, Enrico Felici, Paolo Orizio, Barbara Parma, Silvia Salvatore, and Osvaldo Borrelli.
• From the Department of Pediatrics, Santobono-Pausilipon Children's Hospital.
• Pediatr Emerg Care. 2022 May 1; 38 (5): e1245e1250e1245-e1250.

ObjectivesInfantile acute upper gastrointestinal bleeding involves a decision for therapeutic intervention that most pediatricians first coming into contact with the patient are, not unreasonably, unable to objectively provide. Therefore, some objective tools of individual risk assessment would seem to be crucial. The principal aim of the present study was to investigate the anamnestic and clinical parameters of infants with hematemesis, together with laboratory and instrumental findings, to create a scoring system that may help identify those infants requiring an appropriate and timely application of upper gastrointestinal (GI) endoscopy.MethodsClinical data of infants admitted for hematemesis to the participating centers over the study period were systematically collected. According to the outcome dealing with rebleeding, need for blood transfusion, mortality, finding of GI bleeding lesions, or need for surgical intervention, patients were blindly divided into a group with major clinical severity and a group with minor clinical severity. Univariate and multivariate logistic regressions were conducted to investigate significant prognostic factors for clinical severity.ResultsAccording to our findings, we drafted a practical diagnostic algorithm and a clinical score able to predict the need for timely upper GI endoscopy (BLOVO infant score). Our clinical scoring system was created by incorporating anamnestic factors, clinical parameters, and laboratory findings that emerged as predictors of a worst outcome.ConclusionsWe provided the first objective tool of individual risk assessment for infants with hematemesis, which could be very useful for pediatricians first coming into contact with the patient in the emergency department.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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