Prospective validation of the Glasgow Blatchford scoring system in patients with upper gastrointestinal bleeding in the emergency department

Köksal, Özlem; Özeren, Gülden; Özdemir, Fatma Nurhan; Armağan, Erol; Aydın, Şule; Ayyildiz, Talat

doi:10.4318/tjg.2012.0385

Cited by 15 publications

(17 citation statements)

References 15 publications

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“…Upper gastrointestinal bleeding (UGIB) is a life-threatening event with an overall incidence of 50 to 172 per 100,000 people leading a mortality rate of 2%–15% and a rebleeding rate of 10%–30% 1,2. Thus, proper management of this event with the purpose of lowering adverse consequences is clinically vital specially in UGIB based on higher mortality than lower gastrointestinal bleeding (GIB) 3.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Glasgow-Blatchford score and full Rockall score systems to predict clinical outcomes in patients with upper gastrointestinal bleeding

Mokhtare¹,

Bozorgi²,

Agah³

et al. 2016

CEG

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BackgroundVarious risk scoring systems have been recently developed to predict clinical outcomes in patients with upper gastrointestinal bleeding (UGIB). The two commonly used scoring systems include full Rockall score (RS) and the Glasgow-Blatchford score (GBS). Bleeding scores were assessed in terms of prediction of clinical outcomes in patients with UGIB.Patients and methodsTwo hundred patients (age >18 years) with obvious symptoms of UGIB in the emergency department of Rasoul Akram Hospital were enrolled. Full RS and GBS were calculated. We followed the patients for records of rebleeding and 1-month mortality. A receiver operating characteristic curve by using areas under the curve (AUCs) was used to statistically identify the best cutoff point.ResultsEighteen patients were excluded from the study due to failure to follow-up. Rebleeding and mortality rate were 9.34% (n=17) and 11.53% (n=21), respectively. Regarding 1-month mortality, full RS was better than GBS (AUC, 0.648 versus 0.582; P=0.021). GBS was more accurate in terms of detecting transfusion need (AUC, 0.757 versus 0.528; P=0.001), rebleeding rate (AUC, 0.722 versus 0.520; P=0.002), intensive care unit admission rate (AUC, 0.648 versus 0.582; P=0.021), and endoscopic intervention rate (AUC, 0.771 versus 0.650; P<0.001).ConclusionWe found the full RS system is better for 1-month mortality prediction while GBS system is better for prediction of other outcomes.

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Section: Introductionmentioning

confidence: 99%

Comparison of Glasgow-Blatchford score and full Rockall score systems to predict clinical outcomes in patients with upper gastrointestinal bleeding

Mokhtare¹,

Bozorgi²,

Agah³

et al. 2016

CEG

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“…The included studies were published between years 2007 and 2014, and all studies were conducted in the ED with a 30‐day follow‐up for outcome assessment. Four out of 16 studies were prospective . Eight articles studied individual outcomes of recurrent bleeding, death, and/or need for intervention and did not use a composite .…”

Section: Resultsmentioning

confidence: 99%

“…Eight articles studied individual outcomes of recurrent bleeding, death, and/or need for intervention and did not use a composite . Five studies assessed a composite outcome of intervention and death, and three studies used a composite outcome of recurrent bleeding, death, and need for intervention …”

Section: Resultsmentioning

confidence: 99%

The Predictive Value of Preendoscopic Risk Scores to Predict Adverse Outcomes in Emergency Department Patients With Upper Gastrointestinal Bleeding: A Systematic Review

Ramaekers

Mukarram

Smith

et al. 2016

Academic Emergency Medicine

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“…In a study conducted by Koksa et al the mean Glasgow Blatchford Scoring scores were 7.1 ± 3.8 for 71 low-risk subjects and 11.7 ± 2.9 for 89 high-risk subjects (p<0.001) and a sensitivity and specificity of 86.52% and 69.01% for a cut-off value of >8. 18 In present study, AUROC for prediction of mortality of 0.869 (p<0.001).In a study done by Stanley et al, for the prediction of mortality, the GBS was similar to both the admission Rockall score: area under the curve 0.804 (CI 0.763-0.844) vs. 0.801 (0.751-0.850) P = 0.91, however this was not found in present study. 19 In a study done by Wang CH et al, The AUROC for prediction of mortality obtained for GBS was 0.513.…”

Section: Discussionmentioning

confidence: 99%

Comparison of prediction of outcomes in upper GI bleed using non-endoscopic scoring systems

et al. 2018

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Background: Several scoring systems have been designed for risk stratification and prediction of outcomes in upper GI bleed. Endoscopy plays a major role in the diagnostic and therapeutic management of UGIB patients. However not all patients with UGIB need endoscopy. The objective of the present study was compared the prediction of mortality using different scoring systems in patients with upper GI bleed. A decision tool with a high sensitivity would be able to identify high and low risk patients and for judicious utilization of available resources.Methods: 100 patients were assessed with respect to their clinical parameters, organ dysfunction, pertinent laboratory parameters and five risk assessment scores i.e. clinical Rockall, Glasgow Blatchford, ALBI, PALBI and AIMS65 were calculated.Results: For prediction of outcomes, AIMS65 was superior to the others (AUROC of 0.889), followed by the GBS (AUROC of 0.869), followed by clinical Rockall score (AUROC 0.815), followed by ALBI score (AUROC of 0.765), followed by PALBI score (AUROC of 0.714) all values being statistically significant.Conclusions: The AIMS65 score is best in predicting the mortality in patients with upper GI bleed. The optimum cut off being >2. Though GBS may be better in predicting the need for intervention, it is inferior in predicting the mortality. The newer scores like ALBI and PALBI are inferior to AIMS65 and GBS in predicting mortality.

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Prospective validation of the Glasgow Blatchford scoring system in patients with upper gastrointestinal bleeding in the emergency department

Cited by 15 publications

References 15 publications

Comparison of Glasgow-Blatchford score and full Rockall score systems to predict clinical outcomes in patients with upper gastrointestinal bleeding

Comparison of Glasgow-Blatchford score and full Rockall score systems to predict clinical outcomes in patients with upper gastrointestinal bleeding

The Predictive Value of Preendoscopic Risk Scores to Predict Adverse Outcomes in Emergency Department Patients With Upper Gastrointestinal Bleeding: A Systematic Review

Comparison of prediction of outcomes in upper GI bleed using non-endoscopic scoring systems

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