Performance of the Rockall Scoring System in Predicting the Need for Intervention and Outcomes in Patients with Nonvariceal Upper Gastrointestinal Bleeding in a Brazilian Setting: A Prospective Study

Lima, Jacqueline Miranda de; Montes, Ciro Garcia; Nagasako, Cristiane Kibune; Reis, Glaucia Fernanda Soares Ruppert; Santos, José Olympio Meirelles dos; Guerrazzi, Fábio; Mesquita, Márcio

doi:10.1159/000356313

Cited by 20 publications

(13 citation statements)

References 40 publications

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“…CRS was reported to have an acceptable performance in predicting mortality. 19 Similar to our results, Cassana A et al 20 reported that GBS has no diagnostic validity in predicting mortality in UGIB. Wang CH et al 2 found that GBS, CRS, and PRS have no good performance in predicting 30-day mortality in UGIB.…”

Section: Discussionsupporting

confidence: 89%

Comparison of four scoring systems for risk stratification of upper gastrointestinal bleeding

Tuncer¹,

Yardan²,

Akdemir³

et al. 2018

Pak J Med Sci

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Objective:This study aimed to compare the performances of the Glasgow–Blatchford Bleeding Score (GBS), pre-endoscopic Rockall score (PRS), complete Rockall score (CRS), and Cedars–Sinai Medical Center Predictive Index (CSMCPI) in predicting clinical outcomes in patients with upper gastrointestinal bleeding (UGIB).Methods:Patients who were admitted to the emergency department because of UGIB and underwent endoscopy within the first 24 hour were included in this study. The GBS, PRS, CRS, and CSMCPI were propectively calculated. The performances of these scores were assessed using a receiver operating characteristic curve.Results:A total of 153 patients were included in this study. For the prediction of high-risk patients, area under the curve (AUC) was obtained for GBS (0.912), PRS (0.968), CRS (0.991), and CSMCPI (0.918). For the prediction of rebleeding, AUC was obtained for GBS (0.656), PRS (0.625), CRS (0.701), and CSMCPI (0.612). For the prediction of 30-day mortality, AUC was obtained for GBS (0.658), PRS (0.757), CRS (0.823), and CSMCPI (0.745).Conclusion:These results suggest that effectiveness of CRS is higher than that of other scores in predicting high-risk patients, rebleeding and 30-day mortality in patients with UGIB.

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Section: Discussionsupporting

confidence: 89%

Comparison of four scoring systems for risk stratification of upper gastrointestinal bleeding

Tuncer¹,

Yardan²,

Akdemir³

et al. 2018

Pak J Med Sci

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“…While some authors suggested that the PreRS was not useful in predicting death when compared to the PostRS [14], others presented results admitting that the PreRS can be as good as the PostRS in predicting mortality [15, 16]. In our cohort of patients, the PreRS and PostRS were the only scores which could accurately predict 30-day mortality, exhibiting similar performances.…”

Section: Discussionmentioning

confidence: 61%

Optimizing the Risk Assessment in Upper Gastrointestinal Bleeding: Comparison of 5 Scores Predicting 7 Outcomes

Gonçalves

Barbosa

Xavier

et al. 2018

GE Port J Gastroenterol

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Introduction: Although different scores have been suggested to predict outcomes in the setting of upper gastrointestinal bleeding (UGIB), few comparative studies between simplified versions of older scores and recent scores have been published. We aimed to evaluate the accuracy of pre- (PreRS) and postendoscopic Rockall scores (PostRS), the Glasgow-Blatchford score (GBS) and its simplified version (sGBS), as well as the AIMS65 score in predicting different clinical outcomes. Methods: In this retrospective study, PreRS, PostRS, GBS, sGBS, and AIMS65 score were calculated, and then, areas under the receiver operating characteristic curve were used to evaluate the performance of each score to predict blood transfusion, endoscopic therapy, surgery, admission to intensive/intermediate care unit, length of hospital stay, as well as 30-day rebleeding or mortality. Results: PreRS, PostRS, GBS, and sGBS were calculated for all the 433 included patients, but AIMS65 calculation was only possible for 315 patients. Only the PreRS and PostRS were able to fairly predict 30-day mortality. The GBS and sGBS were good in predicting blood transfusion and reasonable in predicting surgery. None of the studied scores were good in predicting the need for endoscopic therapy, admission to intensive/intermediate care unit, length of hospital stay, and 30-day rebleeding. Conclusions: Owing to the identified limitations, none of the 5 studied scores could be singly used to predict all the clinically relevant outcomes in the setting of UGIB. The sGBS was as precise as the GBS in predicting blood transfusion and surgery. The PreRS and PostRS were the only scores that could predict 30-day mortality. An algorithm using the PreRS and the sGBS as an initial approach to patients with UGIB is presented and suggested.

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“…Concerning mortality, area under the receiver operating characteristic curve (AUROC) of GBS and RS is reported to range from 0.65 to 0.90 and from 0.64 to 0.85, respectively . Concerning the necessity for transfusion, the AUROC of GBS and RS ranged from 0.81 to 0.94 and from 0.70 to 0.79, respectively .…”

Section: Initial Management Of Non‐variceal Upper Gastrointestinal Blmentioning

confidence: 99%

“…Concerning the necessity for transfusion, the AUROC of GBS and RS ranged from 0.81 to 0.94 and from 0.70 to 0.79, respectively . Concerning the necessity for endoscopic hemostasis, the AUROC of GBS and RS ranged from 0.604 to 0.960 and from 0.653 to 0.822, respectively . Both GBS and RS are useful to identify low‐risk cases.…”

Section: Initial Management Of Non‐variceal Upper Gastrointestinal Blmentioning

confidence: 99%

Guidelines for endoscopic management of non‐variceal upper gastrointestinal bleeding

Fujishiro

Iguchi

Kakushima

et al. 2016

Digestive Endoscopy

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Japan Gastroenterological Endoscopy Society (JGES) has compiled a set of guidelines for endoscopic management of non‐variceal upper gastrointestinal bleeding using evidence‐based methods. The major cause of non‐variceal upper gastrointestinal bleeding is peptic gastroduodenal ulcer bleeding. As a result, these guidelines mainly focus on peptic gastroduodenal ulcer bleeding, although bleeding from other causes is also overviewed. From the epidemiological aspect, in recent years in Japan, bleeding from drug‐related ulcers has become predominant in comparison with bleeding from Helicobacter pylori (HP)‐related ulcers, owing to an increase in the aging population and coverage of HP eradication therapy by national health insurance. As for treatment, endoscopic hemostasis, in which there are a variety of methods, is considered to be the first‐line treatment for bleeding from almost all causes. It is very important to precisely evaluate the severity of the patient's condition and stabilize the patient's vital signs with intensive care for successful endoscopic hemostasis. Additionally, use of antisecretory agents is recommended to prevent rebleeding after endoscopic hemostasis, especially for gastroduodenal ulcer bleeding. Eighteen statements with evidence and recommendation levels have been made by the JGES committee of these guidelines according to evidence obtained from clinical research studies. However, some of the statements that are supported by a low level of evidence must be confirmed by further clinical research.

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Performance of the Rockall Scoring System in Predicting the Need for Intervention and Outcomes in Patients with Nonvariceal Upper Gastrointestinal Bleeding in a Brazilian Setting: A Prospective Study

Cited by 20 publications

References 40 publications

Comparison of four scoring systems for risk stratification of upper gastrointestinal bleeding

Comparison of four scoring systems for risk stratification of upper gastrointestinal bleeding

Optimizing the Risk Assessment in Upper Gastrointestinal Bleeding: Comparison of 5 Scores Predicting 7 Outcomes

Guidelines for endoscopic management of non‐variceal upper gastrointestinal bleeding

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