Prediction of the outcome and severity of acute upper gastrointestinal bleeding (UGIB) has significant importance in patient care, disposition, and determining the need for emergent endoscopy. Recent international recommendations endorse using scoring systems for management of non-variceal UGIB patients. To date, different scoring systems have been developed for predicting the risk of 30-day mortality and re-bleeding. We have discussed the screening performance characteristics of Baylor bleeding score, the Rockall risk scoring score, Cedars-Sinai Medical Center predictive index, Glasgow Blatchford score, T-score, and AIMS65 systems, in the present review.
Based on the results of this survey, there are only 3 clinical decision rules that can predict the outcome of UGIB patients, independent from endoscopy. Among these, only Glasgow Blatchford score was highly sensitive for predicting the risk of 30-day mortality and re-bleeding, simultaneously.
Marx J, Walls R, Hockberger R. Rosen's Emergency Medicine-Concepts and Clinical Practice: Elsevier Health Sciences; 2013.
Cheng D, Lu Y, Teller T, Sekhon H, Wu B. A modified Glasgow Blatchford Score improves risk stratification in upper gastrointestinal bleed: a prospective comparison of scoring systems. Alimentary pharmacology & therapeutics. 2012;36(8):782-9.
Zuckerman GR. Acute gastrointestinal bleeding: clinical essentials for the initial evaluation and risk assessment by the primary care physician. The Journal of the American Osteopathic Association. 2000;100(12_suppl):4S-7S.
Cappell MS, Friedel D. Acute nonvariceal upper gastrointestinal bleeding: endoscopic diagnosis and therapy. Medical Clinics of North America. 2008;92(3):511-50.
Yaka E, Yılmaz S, Özgür Doğan N, Pekdemir M. Comparison of the Glasgow‐Blatchford and AIMS65 Scoring Systems for Risk Stratification in Upper Gastrointestinal Bleeding in the Emergency Department. Academic Emergency Medicine. 2015;22(1):22-30.
Saltzman JR, Tabak YP, Hyett BH, Sun X, Travis AC, Johannes RS. A simple risk score accurately predicts in-hospital mortality, length of stay, and cost in acute upper GI bleeding. Gastrointestinal endoscopy. 2011;74(6):1215-24.
Jung SH, Oh JH, Lee HY, Jeong JW, Go SE, You CR, et al. Is the AIMS65 score useful in predicting outcomes in peptic ulcer bleeding? World journal of gastroenterology: WJG. 2014;20(7):1846.
Laursen SB, Hansen JM, De Muckadell OBS. The Glasgow Blatchford score is the most accurate assessment of patients with upper gastrointestinal hemorrhage. Clinical Gastroenterology and Hepatology. 2012;10(10):1130-5. e1.
Tammaro L, Buda A, Di Paolo MC, Zullo A, Hassan C, Riccio E, et al. A simplified clinical risk score predicts the need for early endoscopy in non-variceal upper gastrointestinal bleeding. Digestive and Liver Disease. 2014;46(9):783-7.
Saeed ZA, Winchester CB, Michaletz PA, Woods KL, Graham D. A scoring system to predict rebleeding after endoscopic therapy of nonvariceal upper gastrointestinal hemorrhage, with a comparison of heat probe and ethanol injection. The American journal of gastroenterology. 1993;88(11):1842-9.
Laursen SB. Treatment and prognosis in peptic ulcer bleeding. Danish medical journal. 2014;61(1):B4797-B.
Saeed ZA, Ramirez FC, Hepps KS, Cole RA, Graham DY. Prospective validation of the Baylor bleeding score for predicting the likelihood of rebleeding after endoscopic hemostasis of peptic ulcers. Gastrointestinal endoscopy. 1995;41(6):561-5.
Rockall T, Logan R, Devlin H, Northfield T. Risk assessment after acute upper gastrointestinal haemorrhage. Gut. 1996;38(3):316-21.
Chen I-C, Hung M-S, Chiu T-F, Chen J-C, Hsiao C-T. Risk scoring systems to predict need for clinical intervention for patients with nonvariceal upper gastrointestinal tract bleeding. The American journal of emergency medicine. 2007;25(7):774-9.
Cieniawski D, Kuźniar E, Winiarski M, Matłok M, Kostarczyk W, Pedziwiatr M. Prognostic value of the Rockall score in patients with acute nonvariceal bleeding from the upper gastrointestinal tract. Przeglad lekarski. 2012;70(1):1-5.
Wang C-Y, Qin J, Wang J, Sun C-Y, Cao T, Zhu D-D. Rockall score in predicting outcomes of elderly patients with acute upper gastrointestinal bleeding. World journal of gastroenterology: WJG. 2013;19(22):3466.
Rahman M, Sumon S, Amin M, Kahhar M. Rockall score for risk stratification in adult patients with non-variceal upper gastrointestinal hemorrhage. Mymensingh medical journal: MMJ. 2013;22(4):694-8.
Hay JA, Lyubashevsky E, Elashoff J, Maldonado L, Weingarten SR, Ellrodt AG. Upper gastrointestinal hemorrhage clinical guideline—determining the optimal hospital length of stay. The American journal of medicine. 1996;100(3):313-22.
Silverstein FE, Gilbert DA, Tedesco FJ, Buenger NK, Persing J. The national ASGE survey on upper gastrointestinal bleeding: II. Clinical prognostic factors. Gastrointestinal endoscopy. 1981;27(2):80-93.
Hay JA, Maldonado L, Weingarten SR, Ellrodt AG. Prospective evaluation of a clinical guideline recommending hospital length of stay in upper gastrointestinal tract hemorrhage. Jama. 1997;278(24):2151-6.
Blatchford O, Davidson LA, Murray WR, Blatchford M, Pell J. Acute upper gastrointestinal haemorrhage in west of Scotland: case ascertainment study. BMj. 1997;315(7107):510-4.
Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for uppergastrointestinal haemorrhage. The Lancet. 2000;356(9238):1318-21.
Stanley AJ, Dalton HR, Blatchford O, Ashley D, Mowat C, Cahill A, et al. Multicentre comparison of the Glasgow Blatchford and Rockall scores in the prediction of clinical end‐points after upper gastrointestinal haemorrhage. Alimentary pharmacology & therapeutics. 2011;34(4):470-5.
Tammaro L, Di Paolo MC, Zullo A, Hassan C, Morini S, Caliendo S, et al. Endoscopic findings in patients with upper gastrointestinal bleeding clinically classified into three risk groups prior to endoscopy. World journal of gastroenterology: WJG. 2008;14(32):5046.
Hyett BH, Abougergi MS, Charpentier JP, Kumar NL, Brozovic S, Claggett BL, et al. The AIMS65 score compared with the Glasgow-Blatchford score in predicting outcomes in upper GI bleeding. Gastrointestinal endoscopy. 2013;77(4):551-7.