AIM: To validate the Rockall scoring system for predicting outcomes of rebleeding, and the need for a surgical procedure and death. METHODS: We used data extracted from the Registry of Upper Gastrointestinal Bleeding and Endoscopy including information of 1869 patients with non-variceal upper gastrointestinal bleeding treated in Canadian hospitals. Risk scores were calculated and used to classify patients based on outcomes. For each outcome, we used chi2 goodness-of-fit tests to assess the degree of calibration, and built receiver operating characteristic curves and calculated the area under the curve (AUC) to evaluate the discriminative ability of the scoring system. RESULTS: For rebleeding, the chi2 goodness-of-fit test indicated an acceptable fit for the model [chi2 (8) = 12.83, P = 0.12]. For surgical procedures [chi2 (8) = 5.3, P = 0.73] and death [chi2 (8) = 3.78, P = 0.88], the tests showed solid correspondence between observed proportions and predicted probabilities. The AUC was 0.59 (95% CI: 0.55-0.62) for the outcome of rebleeding and 0.60 (95% CI: 0.54-0.67) for surgical procedures, representing a poor discriminative ability of the scoring system. For the outcome of death, the AUC was 0.73 (95% CI: 0.69-0.78), indicating an acceptable discriminative ability. CONCLUSION: The Rockall scoring system provides an acceptable tool to predict death, but performs poorly for endpoints of rebleeding and surgical procedures.
AIM: To validate the Rockall scoring system for predicting outcomes of rebleeding, and the need for a surgical procedure and death. METHODS: We used data extracted from the Registry of Upper Gastrointestinal Bleeding and Endoscopy including information of 1869 patients with non-variceal upper gastrointestinal bleeding treated in Canadian hospitals. Risk scores were calculated and used to classify patients based on outcomes. For each outcome, we used chi2 goodness-of-fit tests to assess the degree of calibration, and built receiver operating characteristic curves and calculated the area under the curve (AUC) to evaluate the discriminative ability of the scoring system. RESULTS: For rebleeding, the chi2 goodness-of-fit test indicated an acceptable fit for the model [chi2 (8) = 12.83, P = 0.12]. For surgical procedures [chi2 (8) = 5.3, P = 0.73] and death [chi2 (8) = 3.78, P = 0.88], the tests showed solid correspondence between observed proportions and predicted probabilities. The AUC was 0.59 (95% CI: 0.55-0.62) for the outcome of rebleeding and 0.60 (95% CI: 0.54-0.67) for surgical procedures, representing a poor discriminative ability of the scoring system. For the outcome of death, the AUC was 0.73 (95% CI: 0.69-0.78), indicating an acceptable discriminative ability. CONCLUSION: The Rockall scoring system provides an acceptable tool to predict death, but performs poorly for endpoints of rebleeding and surgical procedures.
Authors: Gareth S Dulai; Ian M Gralnek; Tommy T Oei; Dong Chang; Gwen Alofaituli; Jeff Gornbein; Katherine Kahn Journal: Gastrointest Endosc Date: 2002-03 Impact factor: 9.427
Authors: Laura E Targownik; Ian M Gralnek; Gareth S Dulai; Brennan M R Spiegel; Tommy Oei; Charles N Bernstein Journal: Can J Gastroenterol Date: 2003-08 Impact factor: 3.522
Authors: Tommy T Oei; Gareth S Dulai; Ian M Gralnek; Dong Chang; Amy M Kilbourne; Gwen Alofaituli Sale Journal: Am J Gastroenterol Date: 2002-09 Impact factor: 10.864
Authors: Nl de Groot; Mgh van Oijen; K Kessels; M Hemmink; Blam Weusten; R Timmer; Wl Hazen; N van Lelyveld; Wl Curvers; Lc Baak; R Verburg; Jh Bosman; Lrh de Wijkerslooth; J de Rooij; Ng Venneman; M Pennings; K van Hee; Rch Scheffer; Rl van Eijk; R Meiland; Pd Siersema; Aj Bredenoord Journal: United European Gastroenterol J Date: 2014-06 Impact factor: 4.623