Kessarin Thanapirom1, Wiriyaporn Ridtitid1, Rungsun Rerknimitr1, Rattikorn Thungsuk2, Phadet Noophun3, Chatchawan Wongjitrat4, Somchai Luangjaru5, Padet Vedkijkul6, Comson Lertkupinit7, Swangphong Poonsab8, Thawee Ratanachu-ek9, Piyathida Hansomburana10, Bubpha Pornthisarn11, Thirada Thongbai12, Varocha Mahachai1, Sombat Treeprasertsuk1. 1. Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. 2. Division of Gastroenterology, Sawanpracharak Hospital, Nakhon Sawan, Thailand. 3. Division of Gastroenterology, Surin Hospital, Surin, Thailand. 4. Division of Gastroenterology, HRH Princess Maha Chakri Sirindhorn Medical Center-MSMC Hospital, Bangkok, Thailand. 5. Division of Gastroenterology, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand. 6. Division of Gastroenterology, Maharaj Nakhon Si Thammarat Hospital, Nakhon Si Thammarat, Thailand. 7. Division of Gastroenterology, Chonburi Hospital, Chonburi, Thailand. 8. Division of Gastroenterology, Bangkok Hospital, Bangkok, Thailand. 9. Department of Surgery, Rajavithi Hospital, Bangkok, Thailand. 10. Division of Gastroenterology, Rajavithi Hospital, Bangkok, Thailand. 11. Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Thammasat University Hospital, Pathum Thani, Thailand. 12. Division of Gastroenterology, Bangkok Metropolitan Administration General Hospital, Bangkok, Thailand.
Abstract
BACKGROUND AND AIM: Data regarding the efficacy of the Glasgow Blatchford score (GBS), full Rockall score (FRS) and pre-endoscopic Rockall scores (PRS) in comparing non-variceal and variceal upper gastrointestinal bleeding (UGIB) are limited. Our aim was to determine the performance of these three risk scores in predicting the need for treatment, mortality, and re-bleeding among patients with non-variceal and variceal UGIB. METHODS: During January, 2010 and September, 2011, patients with UGIB from 11 hospitals were prospectively enrolled. The GBS, FRS, and PRS were calculated. Discriminative ability for each score was assessed using the receiver operated characteristics curve (ROC) analysis. RESULTS: A total of 981 patients presented with acute UGIB, 225 patients (22.9%) had variceal UGIB. The areas under the ROC (AUC) of the GBS, FRS, and PRS for predicting the need for treatment were 0.77, 0.69, and 0.61 in non-variceal versus 0.66, 0.66, and 0.59 in variceal UGIB. The AUC for predicting mortality and re-bleeding during admission were 0.66, 0.80, and 0.76 in non-variceal versus 0.63, 0.57, and 0.63 in variceal UGIB. AUC score was not statistically significant for predicting need for therapy and clinical outcome in variceal UGIB. The GBS ≤ 2 and FRS ≤ 1 identified low-risk non-variceal UGIB patients for death and re-bleeding during hospitalization. CONCLUSION: In contrast to non-variceal UGIB, the GBS, FRS, and PRS were not precise scores for assessing the need for therapy, mortality, and re-bleeding during admission in variceal UGIB.
BACKGROUND AND AIM: Data regarding the efficacy of the Glasgow Blatchford score (GBS), full Rockall score (FRS) and pre-endoscopic Rockall scores (PRS) in comparing non-variceal and variceal upper gastrointestinal bleeding (UGIB) are limited. Our aim was to determine the performance of these three risk scores in predicting the need for treatment, mortality, and re-bleeding among patients with non-variceal and variceal UGIB. METHODS: During January, 2010 and September, 2011, patients with UGIB from 11 hospitals were prospectively enrolled. The GBS, FRS, and PRS were calculated. Discriminative ability for each score was assessed using the receiver operated characteristics curve (ROC) analysis. RESULTS: A total of 981 patients presented with acute UGIB, 225 patients (22.9%) had variceal UGIB. The areas under the ROC (AUC) of the GBS, FRS, and PRS for predicting the need for treatment were 0.77, 0.69, and 0.61 in non-variceal versus 0.66, 0.66, and 0.59 in variceal UGIB. The AUC for predicting mortality and re-bleeding during admission were 0.66, 0.80, and 0.76 in non-variceal versus 0.63, 0.57, and 0.63 in variceal UGIB. AUC score was not statistically significant for predicting need for therapy and clinical outcome in variceal UGIB. The GBS ≤ 2 and FRS ≤ 1 identified low-risk non-variceal UGIB patients for death and re-bleeding during hospitalization. CONCLUSION: In contrast to non-variceal UGIB, the GBS, FRS, and PRS were not precise scores for assessing the need for therapy, mortality, and re-bleeding during admission in variceal UGIB.
Authors: Joseph Jy Sung; Philip Wy Chiu; Francis K L Chan; James Yw Lau; Khean-Lee Goh; Lawrence Hy Ho; Hwoon-Young Jung; Jose D Sollano; Takuji Gotoda; Nageshwar Reddy; Rajvinder Singh; Kentaro Sugano; Kai-Chun Wu; Chun-Yin Wu; David J Bjorkman; Dennis M Jensen; Ernst J Kuipers; Angel Lanas Journal: Gut Date: 2018-04-24 Impact factor: 23.059