Abstracts of the 23 rd National Congress of Digestive Diseases / Digestive and Liver Disease 49S2 (2017) e73–e223 e199 non-variceal in 2764 (83.1%) and variceal in 560. Outpatients (2646) were driven to the First Aid Department in an ambulance 118: Northern Italy (55.6%), Central Italy (61.5%) and Southern Italy (40.5%) (p<0.0001). In the Northern Regions 64% of emergency endoscopy was performed after a direct request from the First Aid Department, 53.9% in the Centre and 27.7% in the South (p<0.0001). 81% of GI emergency endoscopy was performed in the daytime (8am-8pm) with significant differences among the several geographical areas. Endoscopy was averagely performed within 11 hours in the North, 12 hours in the Centre and 15 hours in the South (p<0.05). Mortality overall result (variceal and non-variceal) was 223 patients, equal to 6.7% but significant difference was present:6.6% in the North, 4.7% in the Centre and 8.1% in the South (p<0.02). No significant differences emerged among the regions with an active network of GI haemorrhage 6.2% (84/1347) versus those without it 7.0% (139/1977) (p=0.367). Overall mortality, evalu- ated according to the seriousness of the clinical case, resulted lower in University Hospitals (OR 0.60 [95% Cl: 0.35 to 1.02]). Mortality rate is lower when endoscopy is performed in the endoscopy room: 6.2% versus 9.2% when performed elsewhere (p<0.0001). Overall 8.4% patients are sent back home directly from the First Aid Department after undergoing endoscopy, but significant differences emerged among the several geographical areas: 12.1% in the North, 10.0% in the Centre and 1.7% in the South (p<0.0001). Conclusions: The mortality due to UGIB significantly differs among North, Centre and South Italy as well as the patients managed as outpatients. The presence of a well-organized network of gastroin- testinal bleeding does not reduce the mortality. Organisational and health care course are different among the several geographical areas and provide different outcomes. P.10.9 OUTPATIENT MANAGEMENT OF PATIENTS WITH GLASGOW-BLATCHFORD BLEEDING SCORE LOW-RISK UPPER-GASTROINTESTINAL HEMORRHAGE: A MULTICENTER VALIDATION STUDY IN ITALY R. Marmo ∗ , M. Soncini, L. Orsini, F. Cipolletta, R. Bennato, M. Guardascione, F. Parente, S. Bargiggia, A. Paterlini, P. Cesaro, A. Bizzotto, B. Germanà, L.G. Cavallaro, A. Dell’Era, G. Costamagna, M.E. Riccioni, C. Marmo, A. Tortora, M. Manno, S. Mangiafico, R. Conigliaro, G. Bresci, S. Metrangolo, A. Merighi, V. Boarino, S. Segato, M. Parravicini, L. Purita, A. Chirico, G. Imperiali, P. Gasparini, C. Bucci, F. Esposito, P. Borgheresi, F.R. De Filippo, G. Baldassarre, M. Franceschi, A. Nucci, F. De Nigris, L. Ferraris, A. Zambelli, C. Londoni, A. Repici, A. Anderloni, M. De Matthaeis, O. Triossi, M.A. Bianco, G. Rotondano, R. Lamanda, A. Lauri, C. De Fanis, P. Di Giorgio, R. Pumpo, L. Furio, A. Russo, A. Andriulli, G. Napolitano, L.M. Montalbano, F. Bazzoli, R.M. Zagari, E. Buscarini, L. Cipolletta, R. De Franchis, G. Spinzi, E. Di Giulio, G. D’Amico, A. Balzano, D. Conte Gruppo Italiano Studio Emorragia Digestiva, Roma, Italy Background and aim: Acute upper gastrointestinal bleeding (AUGIB) remains a significant cause of hospital admission. The Glasgow- Blatchford bleeding score (GBS) is a prognostic score aiming at selecting who might be suitable for outpatient management. This option could be offered in selected patients with the aim to reduce hospital admissions, allowing a more appropriate use of in-patient resources. Aim: To validate the use of GBS for stratifying low-risk bleeding patients for non-admission. Material and methods: Data on consecutive patients admitted for AUGIB were collected. According to the GBS, patients were defined as needing treatment if they had had a blood transfusion or any op- erative or endoscopic intervention to control their hemorrhage, or if they had died, rebleed, or had a substantial fall in haemoglobin con- centration needing blood transfusions; low-risk bleeding patients had a GBS=0. Statistics: Bayesian analysis was conducted consider- ing as gold standard the observed data (intervention Yes–No) and inference the GBS=0 or ≥1. Results: 2607 were included in the study. Mean age was 67.4±15.9, males were 69.1%. Mean hemoglobin value was 9.35±2.6 gr/dl for males and 8.92±2.4 gr/dl in females. Hemodynamic instability was present in 194 (7.4%), 33.2% had pulse rate ≥100 or systolic blood pressure≤100 mmHg. Clinical presentation was melena in 2,192 (84.1%); cardiac failure was present in 655 (25.1%), hepatic disease in 567 (21.7%) and syncope in 298 (11.4%).Overall 2003 (76.8%) needed any treatment. The GBS classified as low-risk 58 patients (2.2%); of these, 33 patients (56.8%) didn’t need any intervention at all. The score equal to 0 had a sensitivity of 7%, specificity 98%, positive predictive value 56% [c.l.95% 43–69] and negative predictive value 22% [c.l.95% 21–23]. Conclusions: The Glasgow-Blatchford bleeding score has been pro- posed by international guidelines as an useful tool for clinical management of low-risk risk patients presenting with UGIB; in our series, 58 (2.2%) out of 2,607 admitted patients were classified as low-risk, but only 33 were a posteriori correctly classified as not needing hospitalization. The score have a good specificity but a low sensitivity and a low positive predictive value in a real life setting. P.10.10 MORTALITY CAUSES FROM ACUTE UPPER GASTROINTESTINAL BLEEDING: A PROSPECTIVE MULTICENTRE OBSERVATIONAL STUDY R. Marmo, M. Soncini, R. Bennato, F. Cipolletta, L. Orsini, M. Guardascione, F. Parente, S. Bargiggia, A. Paterlini, P. Cesaro, A. Bizzotto, B. Germanà, L.G. Cavallaro, R. De Franchis, A. Dell’Era, G. Costamagna, M.E. Riccioni, C. Marmo ∗ , A. Tortora, M. Manno, S. Mangiafico, R. Conigliaro, G. Bresci, S. Metrangolo, A. Merighi, V. Boarino, S. Segato, M. Parravicini, L. Purita, A. Chirico, G. Imperiali, P. Gasparini, C. Bucci, F. Esposito, P. Borgheresi, F.R. De Filippo, G. Baldassarre, M. Franceschi, A. Nucci, F. De Nigris, L. Ferraris, A. Zambelli, C. Londoni, A. Repici, A. Anderloni, M. De Matthaeis, O. Triossi, M.A. Bianco, G. Rotondano, R. Lamanda, A. Lauri, C. De Fanis, P. Di Giorgio, R. Pumpo, L. Furio, A. Russo, A. Andriulli, G. Napolitano, L.M. Montalbano, F. Bazzoli, R.M. Zagari, E. Buscarini, L. Cipolletta, G. Spinzi, E. Di Giulio, G. D’Amico, A. Balzano, D. Conte Gruppo Italiano Studio Emorragia Digestiva, Roma, Italy Background and aim: The epidemiology of the sources and risk factors for upper gastrointestinal bleeding, both from variceal and non-variceal sources, has changed over the time. The increased proportion of older patients with different comorbities, together with an improved life expectancy, modified the risk factors for death by acute bleeding. Aim: To investigate mortality causes in variceal (V) and non-variceal (NV) bleeders in powered cohort Italian patients. Material and methods: Data on patients admitted for GI bleeding were collected from January 2014 to December 2015. Related haemorrhagic death was defined as any event occurred within 30 days after hospital discharge for patients with NV bleeding and 42 days after hospital discharge for those with V bleeding. Mortality due to the bleeding episode was defined as every death occurred within 48 hours of endoscopy (uncontrolled bleeding, death in the absence of other causes, during the surgical act or embolization for uncontrolled bleeding, for complications after surgery or when hypovolemic shock was documented).