Comparison of risk scoring systems for the prediction of clinical outcomes in nonvariceal upper gastrointestinal bleeding: a prospective randomized study

Authors : Muhammed Bahaddin Durak, Batuhan Başpinar, Ibrahim Ethem Güven, Ilhami Yüksel

Pages : 643-649

Doi:10.32322/jhsm.1270718

View : 34 | Download : 75

Publication Date : 2023-05-31

Article Type : Research Article

Abstract :Aim: Non-variceal upper gastrointestinal bleeding (UGIB) is a typical gastrointestinal emergency. Detection of high-risk patients is crucial to organize medical care accordingly. This study aims to compare risk assessment scores for their ability to predict prognosis in nonvariceal-UGIB. Material and Method: Adult patients with nonvariceal-UGIB applied to the emergency department were recruited prospectively. Clinical and Complete Rockall score (RS), Glascow-Blatchford score (GBS), AIMS65, and T-Score were compared for endpoints: (1) need for endoscopic treatment, (2) hospitalization, (3) rebleeding, and (4) 30-day mortality. Results: A total of 469 patients were included. While 133 (28.0%) patients were discharged within 24 hours, 336 (72.0%) were hospitalized. The median length of hospital stay was 6.6 (0.0-8.0) days. Endoscopic treatment and transfusion were required in 109 (23.0%) and 255 (54.0%) patients, respectively. Rebleeding was observed in 36 (8.0%) patients. The 30-day mortality rate was 11.0 %. Complete Rockall score was superior among all risk scores regarding the prediction of the need for endoscopic treatment (AUC: 0.707, p 0.05). AIMS65 score (AUC: 0.810, p 0.05). Conclusion: Complete RS and AIMS65 scores are valuable tools to determine UGIB-related endpoints (need for intervention, hospitalization, rebleeding, and mortality). Identifying high-risk patients using the risk scoring systems and performing endoscopy in this group may improve clinical outcomes, while their sensitivity is inadequate in the low-risk patients.
Keywords : Gastrointestinal hemoraji, Endoskopi, Risk değerlendirmesi, Prognoz