Premium
Comparison of scoring systems for nonvariceal upper gastrointestinal bleeding: a multicenter prospective cohort study
Author(s) -
Yang Hae Min,
Jeon Seong Woo,
Jung Jin Tae,
Lee Dong Wook,
Ha Chang Yoon,
Park Kyung Sik,
Lee Si Hyung,
Yang Chang Heon,
Park Jun Hyung,
Park Youn Sun
Publication year - 2016
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13057
Subject(s) - medicine , upper gastrointestinal bleeding , receiver operating characteristic , prospective cohort study , predictive value of tests , cutoff , cohort study , gastroenterology , endoscopy , physics , quantum mechanics
Summary 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).