Risk Stratification in Cancer Patients with Acute Upper Gastrointestinal Bleeding: Comparison of Glasgow-Blatchford, Rockall and AIMS65, and Development of a New Scoring System

Franco, Matheus Cavalcante; Jang, Sunguk; Martins, Bruno da Costa; Stevens, Tyler; Jairath, Vipul; López, Rocío; Vargo, John J.; Barkun, Alan N.; Maluf‐Filho, Fauze

doi:10.5946/ce.2021.115

Cited by 6 publications

(1 citation statement)

References 26 publications

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“…A retrospective study of six scoring systems (AIM65, GBS, MAP, T-score, ABC and pre-endoscopic Rockall score) found that the accuracy for mortality was highest for ABC score followed by MAP (similar to our study), while for predicting intervention, pre-endoscopic Rockall score was the only useful score. In cancer patients with acute UGIB, AIM65 was better than GBS or Rockall score in predicting mortality (AUC 0.84) [ 33 ]. Another study of 5 scores (pre-RS, full-RS, GBS, modified GBS and AIM65) and 7 outcomes found that the need for transfusion and for surgery was predicted by GBS and modified GBS, 30-day mortality by both pre-endoscopic and full Rockall score but also by AIM65, and the need for endoscopic therapy and admission in ICU was predicted by all 5 scores; none of the scores predicted rebleeding risk [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

The Accuracy of Pre-Endoscopic Scores for Mortality Prediction in Patients with Upper GI Bleeding and No Endoscopy Performed

Cazacu

Alexandru

Statie³

et al. 2023

Diagnostics

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(1) Background: The assessment of mortality and rebleeding rate in upper gastrointestinal bleeding (UGIB) is essential, and several prognostic scores have been proposed. Some patients with UGIB did not undergo endoscopy, either because they refused the procedure, suffered from alcohol withdrawal symptoms or altered general status, or because the bleeding was severe enough to cause death before the endoscopy. The mortality risk in the subgroup of patients without endoscopy is poorly evaluated in the literature. (2) Methods: The purpose of the study was to identify the most useful scores for the assessment of in-hospital mortality in patients with UGIB with no endoscopy performed and no known etiology. A total of 198 patients with UGIB and no endoscopy performed were admitted between January 2017 and December 2021 and the accuracy of 12 prognostic scores and the Charlson comorbidity index for in-hospital mortality prediction were analyzed, as well as Child–Pugh Turcotte (CPT) and Meld scores in patients with cirrhosis. (3) Results: The mortality rate was 37.9%, higher than in variceal (21.9%, p < 0.0001) and non-variceal bleeding (7.4%, p < 0.0001). The most accurate scores by AUC were the International Bleeding score (INBS, 0.844), Glasgow Blatchford (0.783), MAP score (0.78), Iino (0.766), AIM65 and modified N-score (0.745 each), modified Glasgow-Blatchford (0.73), H3B2 and N-score (0.701); Rockall, Baylor, and T-score had an AUC below 0.7. MELD score was superior to CPT in patients with cirrhosis (AUC 0.811 versus 0.670). (4) Conclusions: The mortality rate in UGIB with no endoscopy was higher than in both variceal and non-variceal bleeding and was higher in the pandemic period but with no statistical significance (45.3% versus 32.14%, p = 0.0586), mainly because of positive cases. Only one case of rebleeding was noted; the hospitalization period was significantly shorter. The most accurate score was International Bleeding Score; the MELD score had a higher but moderate accuracy compared with CPT in patients with cirrhosis.

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Section: Discussionmentioning

confidence: 99%

The Accuracy of Pre-Endoscopic Scores for Mortality Prediction in Patients with Upper GI Bleeding and No Endoscopy Performed

Cazacu

Alexandru

Statie³

et al. 2023

Diagnostics

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Endoscopic Management of Tumor Bleeding

Dang,

Monachese

2024

Gastrointestinal Endoscopy Clinics of North America

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Comparative diagnostic utility of Rockall and Glasgow-Blatchford scores in non-variceal upper gastrointestinal bleeding: a systematic review and meta-analysis

Kozai,

Tan,

Nebrejas

et al. 2024

European Journal of Gastroenterology &Amp; Hepatology

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Introduction The Rockall score and Glasgow-Blatchford score (GBS) are two scoring systems validated in the evaluation of upper gastrointestinal bleeding (UGIB). However, no meta-analysis exists to summarize the current data and clarify the use of Rockall score and GBS focusing on non-variceal UGIB. We aimed to evaluate and compare the utility of the Rockall score and GBS in predicting clinical outcomes in non-variceal UGIB. Methods We conducted a systematic review and meta-analysis, searching the MEDLINE and EMBASE databases for all peer-reviewed articles using the terms including ‘Glasgow-Blatchford’, ‘Rockall’, and ‘gastrointestinal bleed’ from their inception to 22 March 2023. Outcomes included mortality, rebleeding, need for blood transfusion, and need for surgical intervention. Results Seven studies with 755 participants with non-variceal bleeding were included in the analysis. Pooled analysis demonstrated no difference in the area under the receiver operating characteristic (AUROC) between GBS and Rockall score to predict mortality [weighted mean difference (WMD) = 0.01, 95% CI: −0.06 to 0.08] or rebleeding (WMD = 0.04, 95% CI: −0.03 to 0.11). GBS had a higher AUROC to predict the outcomes compared to Rockall score for the needs for transfusion (WMD = 0.09, 95% CI: 0.01–0.16) and surgical intervention (WMD = 0.21, 95% CI: 0.14–0.29). Conclusion The GBS could be superior to the Rockall score in predicting the needs for transfusion and surgical intervention in non-variceal UGIB. However, both scores demonstrate low performance for predicting mortality or rebleeding.

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Risk Stratification in Cancer Patients with Acute Upper Gastrointestinal Bleeding: Comparison of Glasgow-Blatchford, Rockall and AIMS65, and Development of a New Scoring System

Cited by 6 publications

References 26 publications

The Accuracy of Pre-Endoscopic Scores for Mortality Prediction in Patients with Upper GI Bleeding and No Endoscopy Performed

The Accuracy of Pre-Endoscopic Scores for Mortality Prediction in Patients with Upper GI Bleeding and No Endoscopy Performed

Endoscopic Management of Tumor Bleeding

Comparative diagnostic utility of Rockall and Glasgow-Blatchford scores in non-variceal upper gastrointestinal bleeding: a systematic review and meta-analysis

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