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J Gastroenterol Hepatol. 2016 Jan;31(1):119-25. doi: 10.1111/jgh.13057.

Comparison of scoring systems for nonvariceal upper gastrointestinal bleeding: a multicenter prospective cohort study.

Author information

1
Department of Internal Medicine, Kyungpook National University Hospital/ School of Medicine.
2
Department of Internal Medicine, Catholic University of Daegu School of Medicine.
3
Department of Internal Medicine, Gyeongsang National University Hospital, Jinju.
4
Department of Internal Medicine, Keimyung University School of Medicine.
5
Department of Internal Medicine, Yeungnam University College of Medicine, Daegu.
6
Department of Internal Medicine, Dongguk University School of Medicine, Gyeongju.
7
Department of Internal Medicine, Soonchunhyang University Hospital, Gumi, South Korea.

Abstract

BACKGROUND AND AIM:

The Glasgow-Blatchford score (GBS) and Rockall score (RS) are widely used to assess risk in patients with upper gastrointestinal bleeding (UGIB). We compared both scoring systems and evaluated their clinical usefulness.

METHODS:

Between February 2011 and December 2013, 1584 patients with nonvariceal UGIB were included in the study. A prospective study was conducted to compare the performance of the GBS, pre-RS, and full RS. We compared the performance of these scores using receiver operating characteristic curves.

RESULTS:

For prediction of the need for hospital-based intervention, the GBS was similar to the full RS (area under the receiver operating characteristic curves [AUROC] 0.705 vs 0.727; P = 0.282) and superior to the pre-RS (AUROC 0.705 vs 0.601; P < 0.0001). In predicting death, the full RS was superior to the GBS (AUROC 0.758 vs 0.644; P = 0.0006) and similar to the pre-RS (AUROC 0.758 vs 0.754; P = 0.869). In predicting rebleeding, the full RS was superior to both GBS (AUROC 0.642 vs 0.585; P = 0.031) and pre-RS (AUROC 0.642 vs 0.593; P = 0.0003). Of 1584 patients, 13 (0.8%) scored 0 on the GBS. Therapeutic intervention was not performed in any of these patients.

CONCLUSIONS:

The GBS is more useful than the pre-RS for predicting the need for hospital-based intervention. A cutoff value of 0 for low-risk patients who might be suitable for outpatient management is useful. The full RS is helpful in predicting death. None of the systems accurately predict rebleeding with a low AUROC. (

CLINICAL TRIAL:

cris.nih.go.kr/KCT0000514).

KEYWORDS:

intervention; mortality; upper gastrointestinal bleeding

PMID:
26211939
DOI:
10.1111/jgh.13057
[Indexed for MEDLINE]

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