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Forrest Classification (Peptic Re-bleed Risk)
Forrest Classification: Endoscopic assessment of peptic ulcer bleeding. Predicts rebleeding risk and guides therapeutic intervention.
Guidelines & Evidence
Verified
Last Review: 2026
When to Use
When to Use
Endoscopic assessment of peptic ulcers presenting with acute gastrointestinal bleeding
To guide the decision for endoscopic haemostasis (thermal, clips, or injectables)
To predict the risk of re-bleeding and associated mortality
To assist in triage decisions (ICU vs. ward monitored discharge)
Timing of Endoscopy
Clinical guidelines (ACG/ESGE) recommend performing endoscopy within 24 hours of presentation. In high-risk patients (haemodynamic instability), earlier endoscopy (< 12 hours) should be considered after resuscitation.