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Evaluation of scoring systems without endoscopic findings for predicting outcomes in patients with upper gastrointestinal bleeding.
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- Author(s): Il-Gyu Ko; Sung-Eun Kim; Bok Soon Chang; Min Seob Kwak; Jin Young Yoon; Jae Myung Cha; Hyun Phil Shin; Joung Il Lee; Sang Hyun Kim; Jin Hee Han; Jung Won Jeon; Ko, Il-Gyu; Kim, Sung-Eun; Chang, Bok Soon; Kwak, Min Seob; Yoon, Jin Young; Cha, Jae Myung; Shin, Hyun Phil; Lee, Joung Il; Kim, Sang Hyun
- Source:
BMC Gastroenterology; 12/12/2017, Vol. 17, p1-8, 8p, 5 Charts, 1 Graph- Subject Terms:
GASTROINTESTINAL diseases; GASTROINTESTINAL disease treatment; ENDOSCOPY; MORTALITY; HOSPITAL emergency services; PATIENTS; GASTROINTESTINAL hemorrhage diagnosis; GASTROINTESTINAL hemorrhage treatment; BLOOD transfusion; GASTROINTESTINAL hemorrhage; SURGICAL hemostasis; PHARMACOKINETICS; PROGNOSIS; RISK assessment; RETROSPECTIVE studies; SEVERITY of illness index; RECEIVER operating characteristic curves; ENDOSCOPIC gastrointestinal surgery - Source:
- Additional Information
- Abstract:
Background: Risk scoring systems are used to evaluate patients with upper gastrointestinal bleeding (UGIB). We compared Glasgow-Blatchford score (GBS), modified GBS (mGBS), and Pre-endoscopy Rockall score (Pre-E RS) for immediate application without endoscopic findings in predicting the need of interventions and the 30-day mortality in patients with UGIB.Methods: Patients who visited the emergency room with UGIB from January 2007 to June 2016 were included. GBS, mGBS, and Pre-E RS were obtained for all patients. The area under the receiver-operating characteristic curves (AUC) was used to assess the accuracy of the scoring systems to determine the need for interventions and 30-day mortality. Also, we investigated the potential cutoff scores for predicting 30-day mortality and the need for interventions.Results: In predicting the need for interventions, GBS (AUC = 0.727) and mGBS (AUC = 0.733) outperformed Pre-E RS (AUC = 0.564, P < 0.0001). In predicting 30-day mortality, Pre-E RS (AUC = 0.929) outperformed GBS (AUC = 0.664, P < 0.0001) and mGBS (AUC = 0.652, P < 0.0001). Based on AUC analyses of sensitivities and specificities, the optimal cutoff mGBS and GBS for the need for interventions was 9 (70.71% sensitivity, 89.35% specificity) and 9 (73.57% sensitivity, 82.90% specificity) respectively, and optimal cutoff Pre-E RS for 30-day mortality was 4 (88.0% sensitivity, 97.52% specificity).Conclusions: GBS and mGBS are considered to be moderately accurate in making an early decision about the need of interventions in patients with UGIB. Pre-E RS is considered to be highly accurate in early detection of patients at high risk for 30-day mortality without endoscopic findings. In addition, we suggested potential cutoff scores to predict the need of interventions for GBS and mGBS, and 30-day mortality for Pre-E RS. Further studies are needed to confirm the clinical applicability of results. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of BMC Gastroenterology is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Abstract:
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