Full and Modified Glasgow-Blatchford Bleeding Score in Predicting the Outcome of Patients with Acute Upper Gastrointestinal Bleeding; a Diagnostic Accuracy Study
Archives of Academic Emergency Medicine,
Vol. 6 No. 1 (2018),
1 January 2018
,
Page e31
https://doi.org/10.22037/aaem.v6i1.74
Abstract
Introduction:Â Screening of high risk patients and accelerating their treatment measures can reduce the burden of the disease caused by acute upper gastrointestinal (GI) bleeding. This study aimed to compare the full and modified Glasgow-Blatchford Bleeding Score (GBS and mGBS) in prediction of in-hospital outcomes of upper GI bleeding.
Methods:Â In the present retrospective cross-sectional study, the accuracy of GBS and mGBS models were compared in predicting the outcome of patients over 18 years of age with acute upper GI bleeding confirmed via endoscopy, presenting to the emergency departments of 3 teaching hospitals during 4 years.
Results: 330 cases with the mean age of 59.07 ± 19.00 years entered the study (63.60% male). Area under the curve of GBS and mGBS scoring systems were 0.691 and 0.703, respectively, in prediction of re-bleeding (p = 0.219), 0.562 and 0.563 regarding need for surgery (p = 0.978), 0.549 and 0.542 for endoscopic intervention (p = 0.505), and 0.767 and 0.770 regarding blood transfusion (p = 0.753). Area under the ROC curve of GBS scoring system regarding need for hospitalization in intensive care unit (0.589 vs. 0.563; p = 0.035) and mortality (0.597 vs. 0.564; p = 0.011) was better but the superiority was not clinically significant.
Conclusion:Â GBS and mGBS scoring systems have similar accuracy in prediction of the probability of re-bleeding, need for blood transfusion, surgery and endoscopic intervention, hospitalization in intensive care unit, and mortality of patients with acute upper GI bleeding.- Gastrointestinal hemorrhage
- decision support techniques
- outcome assessment (Health Care)
- hospital mortality
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References
Lassen A, Hallas J, De Muckadell OB. Complicated and uncomplicated peptic ulcers in a Danish county 1993–2002: a population-based cohort study. The American journal of gastroenterology. 2006;101(5):945.
Van Leerdam M, Vreeburg E, Rauws E, Geraedts A, Tijssen J, Reitsma J, et al. Acute upper GI bleeding: did anything change?: Time trend analysis of incidence and outcome of acute upper GI bleeding between 1993/1994 and 2000. The American journal of gastroenterology. 2003;98(7):1494-9.
Targownik LE, Nabalamba A. Trends in management and outcomes of acute nonvariceal upper gastrointestinal bleeding: 1993–2003. Clinical Gastroenterology and Hepatology. 2006;4(12):1459-66. e1.
Van Leerdam M. Epidemiology of acute upper gastrointestinal bleeding. Best Practice & Research Clinical Gastroenterology. 2008;22(2):209-24.
Tramèr MR, Moore RA, Reynolds DJM, McQuay HJ. Quantitative estimation of rare adverse events which follow a biological progression: a new model applied to chronic NSAID use. Pain. 2000;85(1-2):169-82.
Lim C, Vani D, Shah S, Everett S, Rembacken B. The outcome of suspected upper gastrointestinal bleeding with 24-hour access to upper gastrointestinal endoscopy: a prospective cohort study. Endoscopy. 2006;38(06):581-5.
Kolkman J, Meuwissen S. A review on treatment of bleeding peptic ulcer: a collaborative task of gastroenterologist and surgeon. Scandinavian Journal of Gastroenterology. 1996;31(sup218):16-25.
Camellini L, Merighi A, Pagnini C, Azzolini F, Guazzetti S, Scarcelli A, et al. Comparison of three different risk scoring systems in non-variceal upper gastrointestinal bleeding. Digestive and liver disease. 2004;36(4):271-7.
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 endâ€points after upper gastrointestinal haemorrhage. Alimentary pharmacology & therapeutics. 2011;34(4):470-5.
Enns RA, Gagnon YM, Barkun AN, Armstrong D, Gregor JC, Fedorak RN, et al. Validation of the Rockall scoring system for outcomes from non-variceal upper gastrointestinal bleeding in a Canadian setting. World journal of gastroenterology: WJG. 2006;12(48):7779.
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.
Yaka E, Yılmaz S, Özgür DoÄŸan N, Pekdemir M. Comparison of the Glasgowâ€Blatchford and AIMS65 scoring systems for risk stratification in upper gastrointestinal bleeding in the emergency department. Academic Emergency Medicine. 2015;22(1):22-30.
Quach DT, Dao NH, Dinh MC, Nguyen CH, Ho LX, Nguyen N-DT, et al. The performance of a modified Glasgow Blatchford score in predicting clinical interventions in patients with acute nonvariceal upper gastrointestinal bleeding: a Vietnamese prospective multicenter cohort study. Gut and liver. 2016;10(3):375.
Balaban DV, Strambu V, Florea BG, Cazan AR, Bratucu M, Jinga M. Predictors for in-hospital mortality and need for clinical intervention in upper GI bleeding: a 5-year observational study. Chirurgia (Bucharest, Romania : 1990). 2014;109(1):48-54.
Laursen SB, Hansen JM, Schaffalitzky de Muckadell OB. The Glasgow Blatchford score is the most accurate assessment of patients with upper gastrointestinal hemorrhage. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2012;10(10):1130-5.e1.
Yang HM, Jeon SW, Jung JT, Lee DW, Ha CY, Park KS, et al. Comparison of scoring systems for nonvariceal upper gastrointestinal bleeding: a multicenter prospective cohort study. Journal of gastroenterology and hepatology. 2016;31(1):119-25.
Cheng DW, Lu YW, Teller T, Sekhon HK, Wu BU. A modified Glasgow Blatchford Score improves risk stratification in upper gastrointestinal bleed: a prospective comparison of scoring systems. Aliment Pharmacol Ther. 2012;36(8):782-9.
Quach DT, Dao NH, Dinh MC, Nguyen CH, Ho LX, Nguyen NT, et al. The Performance of a Modified Glasgow Blatchford Score in Predicting Clinical Interventions in Patients with Acute Nonvariceal Upper Gastrointestinal Bleeding: A Vietnamese Prospective Multicenter Cohort Study. Gut Liver. 2015.
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