Cheng-Hsien Wang1,2, Ming-Szu Hung3,4, Kuan-Han Wu4,5, Yi-Chuan Chen1,2. 1. Chang Gung Memorial Hospital Department of Emergency Medicine Chiayi County Taiwan. 2. Chang Gung University of Science and Technology Department of Nursing Chiayi County Taiwan. 3. Chang Gung Memorial Hospital Division of Thoracic Oncology, Department of Pulmonary and Critical Care Medicine Chiayi County Taiwan. 4. Chang Gung University College of Medicine School of medicine Taoyuan County Taiwan. 5. Chang Gung University College of Medicine Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan.
Abstract
BACKGROUND: The role of scoring systems in detecting outcomes of non-variceal upper gastrointestinal bleeding in Taiwanese population remains uncertain. AIMS: The aim of our study was to compare Glasgow-Blatchford score with pre-endoscopic Rockall score in their utilities in predicting clinical outcomes in Taiwanese population. METHODS: We designed a prospective study to compare the performance of the Glasgow-Blatchford score and pre-endoscopic Rockall score in predicting endoscopic therapy, rebleeding and 30-day mortality in non-variceal upper gastrointestinal bleeding patients. The area under receiver operating characteristic curve was analyzed. 234 consecutive patients admitted during a 8-month period were enrolled. RESULTS: For prediction of therapeutic endoscopy, area under receiver operating characteristic curve was obtained for Glasgow-Blatchford score (0.629), and pre-endoscopic Rockall score (0.599). For prediction of rebleeding, area under receiver operating characteristic curve was obtained for Glasgow-Blatchford score (0.687), and pre-endoscopic Rockall score (0.581). For prediction of mortality, area under receiver operating characteristic curve was obtained for Glasgow-Blatchford score (0.505), and pre-endoscopic Rockall score (0.734). CONCLUSIONS: In detecting low risk patients requiring endoscopy therapy, the AUC for GBS shows that it is a poor stratification tool, and the AUC for PRS reveals that it is a worthless stratification test. In detecting rebleeding, Glasgow-Blatchford score has a better performance than pre-endoscopic Rockall score. In contrast, pre-endoscopic Rockall score has a better performance in predicting 30-day mortality than Glasgow-Blatchford score.
BACKGROUND: The role of scoring systems in detecting outcomes of non-variceal upper gastrointestinal bleeding in Taiwanese population remains uncertain. AIMS: The aim of our study was to compare Glasgow-Blatchford score with pre-endoscopic Rockall score in their utilities in predicting clinical outcomes in Taiwanese population. METHODS: We designed a prospective study to compare the performance of the Glasgow-Blatchford score and pre-endoscopic Rockall score in predicting endoscopic therapy, rebleeding and 30-day mortality in non-variceal upper gastrointestinal bleeding patients. The area under receiver operating characteristic curve was analyzed. 234 consecutive patients admitted during a 8-month period were enrolled. RESULTS: For prediction of therapeutic endoscopy, area under receiver operating characteristic curve was obtained for Glasgow-Blatchford score (0.629), and pre-endoscopic Rockall score (0.599). For prediction of rebleeding, area under receiver operating characteristic curve was obtained for Glasgow-Blatchford score (0.687), and pre-endoscopic Rockall score (0.581). For prediction of mortality, area under receiver operating characteristic curve was obtained for Glasgow-Blatchford score (0.505), and pre-endoscopic Rockall score (0.734). CONCLUSIONS: In detecting low risk patients requiring endoscopy therapy, the AUC for GBS shows that it is a poor stratification tool, and the AUC for PRS reveals that it is a worthless stratification test. In detecting rebleeding, Glasgow-Blatchford score has a better performance than pre-endoscopic Rockall score. In contrast, pre-endoscopic Rockall score has a better performance in predicting 30-day mortality than Glasgow-Blatchford score.
Authors: Sandy H Pang; Jessica Y L Ching; James Y W Lau; Joseph J Y Sung; David Y Graham; Francis K L Chan Journal: Gastrointest Endosc Date: 2010-06 Impact factor: 9.427
Authors: A J Stanley; H R Dalton; O Blatchford; D Ashley; C Mowat; A Cahill; D R Gaya; E Thompson; U Warshow; N Hare; M Groome; G Benson; W Murray Journal: Aliment Pharmacol Ther Date: 2011-06-26 Impact factor: 8.171
Authors: M E van Leerdam; E M Vreeburg; E A J Rauws; A A M Geraedts; J G P Tijssen; J B Reitsma; G N J Tytgat Journal: Am J Gastroenterol Date: 2003-07 Impact factor: 10.864