Scoring systems for peptic ulcer bleeding: which one to use?

被引:5
|
作者
Ivan Budimir [1 ]
Sanja Stojsavljevi?
Neven Bar?i?
Alen Bi??anin
Gorana Miro?evi?
Sven Bohnec [3 ]
Lora Stanka Kirigin [2 ]
Tajana Pavi?
Neven Ljubi?i?
机构
[1] Division of Gastroent-erology, Department of Internal Medicine, “Sestre Milosrdnice” University Hospital Center
[2] Division of Endo-crinology, Department of Internal Medicine, “Sestre Milosrdnice” University Hospital Center
[3] Gastronterologie, Allgemeine Innere Medizin und Geriatrie, Rems -Murr Klinik Winnenden
关键词
Upper gastrointestinal bleeding; Peptic ulcer bleeding; Glasgow-Blatchford score; Rockall score; Baylor bleeding score;
D O I
暂无
中图分类号
R573.1 [溃疡病];
学科分类号
1002 ; 100201 ;
摘要
AIM To compare the Glasgow-Blatchford score(GBS), Rockall score(RS) and Baylor bleeding score(BBS) in predicting clinical outcomes and need for interventions in patients with bleeding peptic ulcers. METHODS Between January 2008 and December 2013, 1012consecutive patients admitted with peptic ulcer bleeding(PUB) were prospectively followed. The pre-endoscopic RS, BBS and GBS, as well as the post-endoscopic diagnostic scores(RS and BBS) were calculated for all patients according to their urgent upper endoscopy findings. Area under the receiver-operating characteristics(AUROC) curves were calculated for the prediction of lethal outcome, rebleeding, needs for blood transfusion and/or surgical intervention, and the optimal cutoff values were evaluated.RESULTS PUB accounted for 41.9% of all upper gastrointestinal tract bleeding, 5.2% patients died and 5.4% patients underwent surgery. By comparing the AUROC curves of the aforementioned pre-endoscopic scores, the RS best predicted lethal outcome(AUROC 0.82 vs 0.67 vs0.63, respectively), but the GBS best predicted need for hospital-based intervention or 30-d mortality(AUROC0.84 vs 0.57 vs 0.64), rebleeding(AUROC 0.75 vs 0.61 vs 0.53), need for blood transfusion(AUROC 0.83 vs0.63 vs 0.58) and surgical intervention(0.82 vs 0.63 vs 0.52) The post-endoscopic RS was also better than the post-endoscopic BBS in predicting lethal outcome(AUROC 0.82 vs 0.69, respectively).CONCLUSION The RS is the best predictor of mortality and the GBS is the best predictor of rebleeding, need for blood transfusion and/or surgical intervention in patients with PUB. There is no one ’perfect score’ and we suggest that these two tests be used concomitantly.
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页码:7450 / 7458
页数:9
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