Comparison of risk scoring systems in predicting clinical outcome at upper gastrointestinal bleeding patients in an emergency unit

Dicu, Daniela; Pop, Felicia; Ionescu, Daniela; Dicu, Tiberius

doi:10.1016/j.ajem.2012.06.009

Cited by 55 publications

(50 citation statements)

References 24 publications

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“…Previous studies showed that GBS was generally superior to other scores in predicting the need for a transfusion. 13,14 The results of this study confirm its superiority. This finding is likely because the GBS includes the measurement of hemoglobin levels on admission.…”

Section: Discussionsupporting

confidence: 71%

“…6,12,18,20,26 The GBS was superior to the AIMS65 in the prediction of high-risk patients in this study, with similar AUCs to previous reports. 11,14 Its superiority is most likely related to the system being developed to detect high-risk patients requiring clinical interventions, including transfusions. The high accuracy of the GBS in this regard may aid physicians in decision-making regarding endoscopy timing, patient disposition, level of care, and resource utilization.…”

Section: Discussionmentioning

confidence: 99%

“…11 Some studies have shown that the GBS outperforms the RS in predicting interventions or composite clinical outcomes. [12][13][14] Research has also demonstrated that it is superior to the RS in identifying patients with low-risk upper GI bleeding requiring no intervention who might be safely managed as outpatients. 1,12 The AIMS65 score was recently derived from a large database and validated to predict inpatient mortality.…”

mentioning

confidence: 99%

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Comparison of the Glasgow‐Blatchford and AIMS65 Scoring Systems for Risk Stratification in Upper Gastrointestinal Bleeding in the Emergency Department

Yaka

Yılmaz

Doğan

et al. 2014

Academic Emergency Medicine

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ObjectivesThe aim of this study was to compare the performance of the Glasgow‐Blatchford and the AIMS65 scoring systems as early risk assessment tools for accurately identifying patients with upper gastrointestinal (GI) bleeding who are at a low risk of requiring clinical interventions, including emergency endoscopy. The secondary objective was to compare their performance regarding relevant clinical outcomes.MethodsData were collected prospectively over a 2‐year period in the emergency department of a university hospital. Adult patients with upper GI bleeding from either variceal or nonvariceal sources were included. Composite clinical outcomes consisted of a need for surgical or endoscopic intervention, rebleeding, intensive care unit admission, or in‐hospital mortality. Patients who required blood transfusions or suffered composite clinical outcomes were considered high‐risk patients. Glasgow‐Blatchford score (GBS) and AIMS65 score were calculated for each patient. The sensitivity and specificity of the scoring systems were calculated. The areas under the receiver‐operating characteristic curve (AUC) of the scores were compared.ResultsThere were 254 patients in the study, of whom 163 (64.2%) were men. The median age was 61 years (interquartile range = 45 to 72 years). Among the patients, 211 (83.1%) underwent endoscopy, of whom 49 (19.3%) required endoscopic intervention to achieve hemostasis. Five (2%) patients required surgical intervention. Rebleeding was observed in 33 (13%) patients. A total of 143 (56.3%) patients received blood transfusions. A total of 152 (59.8%) were defined as high risk. Eighty‐one (31.9%) experienced at least one component of the composite clinical outcomes, 18 (7.1%) of whom suffered in‐hospital mortality. A GBS of 0 was observed in 16 patients (6.3%) in the study group. Two of these were high‐risk patients. A total of 101 (39.8%) patients had AIMS65 scores of 0. Thirty‐four of these were high‐risk patients. A GBS of 0 had higher sensitivity than an AIMS65 score of 0 (98.68% vs. 77.6%). The negative predictive values of the GBS and AIMS65 of 0 were 87.5 and 66.3%, respectively. The GBS and AIMS65 were similar with regard to the composite outcome prediction, with AUCs of 0.795 (95% confidence interval [CI] = 0.74 to 0.843) and 0.746 (95% CI = 0.688 to 0.798), respectively (p = 0.137). The scores were also similar with respect to predicting in‐hospital mortality (AUCs of 0.85 vs. 0.81; p = 0.342). The GBS was superior to the AIMS65 in identifying high‐risk patients, with AUCs of 0.896 (95% CI = 0.85 to 0.93) and 0.771 (95% CI = 0.714 to 0.821; p < 0.001), respectively. The GBS was also more accurate than the AIM65 in predicting the need for blood transfusions (AUCs of 0.904 vs. 0.796; p < 0.001) and interventions (AUCs of 0.727 vs. 0.647; p = 0.05).ConclusionsThese results suggest that the GBS has superior sensitivity relative to the AIMS65 in identifying patients who were not likely to require interventions, including emergency endoscopy. Additional work to determine the use in real‐time decision making may be warranted and helpful in providing guidance to clinicians.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Comparison of the Glasgow‐Blatchford and AIMS65 Scoring Systems for Risk Stratification in Upper Gastrointestinal Bleeding in the Emergency Department

Yaka

Yılmaz

Doğan

et al. 2014

Academic Emergency Medicine

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“…Previous studies have shown that for predicting the need for a blood transfusion, the GBS was better than other scores (3,17,20). A comparison of both scores for prognosticating the need for transfusion shows that the GBS has a higher predictive power than the AIMS-65 score (AUC=0.660 vs. AUC=0.611; p=0.001).…”

Section: Discussionmentioning

confidence: 83%

Comparison of the AIMS-65 Score with the Glasgow-Blatchford Score in Upper Gastrointestinal Bleed in the Emergency Department

Venkat¹,

Cattamanchi²,

Madali³

et al. 2017

EAJEM

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“…Patients with a score of 2 or below are at low risk of rebleeding and death. Effectiveness of Rockall scoring system is studied in several countries in Europe 16 , Asia 17 , and America 18 . They found Rockall scoring system is very effective in predicting death from acute UGIH.…”

Section: Introductionmentioning

confidence: 99%

Risk Assessment of Acute Upper Gastrointestinal Haemorrhage with Rockall Score In DMCH

et al. 2018

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Comparison of risk scoring systems in predicting clinical outcome at upper gastrointestinal bleeding patients in an emergency unit

Cited by 55 publications

References 24 publications

Comparison of the Glasgow‐Blatchford and AIMS65 Scoring Systems for Risk Stratification in Upper Gastrointestinal Bleeding in the Emergency Department

Comparison of the Glasgow‐Blatchford and AIMS65 Scoring Systems for Risk Stratification in Upper Gastrointestinal Bleeding in the Emergency Department

Comparison of the AIMS-65 Score with the Glasgow-Blatchford Score in Upper Gastrointestinal Bleed in the Emergency Department

Risk Assessment of Acute Upper Gastrointestinal Haemorrhage with Rockall Score In DMCH

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