A series of clinical and endoscopic signs have been described, which have predictive value in the evolution and mortality of peptic ulcer hemorrhage. Accepted clinical parameters of severity are: age above 60, associated severe disease, hypovolemic shock at admission. Endoscopic prognostic signs for persistence or recurrence of hemorrhage are: active bleeding, either spurting or oozing, a visible vessel. Other endoscopic signs such as the presence of a dark clot, black dots, red spots over the ulcer, do not have prognostic value.
In conclusion: The presence of active bleeding or a visible vessel in a patient with peptic ulcer bleeding, especially when aged more than 60 and with associated severe disease is indicative of recurrence or persistence of the hemorrhage and of greater mortality. In this group of patients therapeutic endoscopy is mandatory.