Predictive value of different scoring systems for patients with acute non-variceal upper gastrointestinal bleeding
Objective To explore the predictive ability of four scoring systems[Glasgow-Blatchford risk score(GBS),pre-endoscopic Rockall score(PRS),post-endoscopic complete Rockall score(RS)and AIMS65 scoring system]in clinical intervention and prognosis of patients with acute non-variceal upper gas-trointestinal bleeding(ANVUGIB),so as to guide clinical practice.Methods A total of 77 patients with AN-VUGIB admitted to the Department of Gastroenterology and Intensive Care Unit(ICU)of the hospital from January 2021 to December 2022 were selected as the research objects.The clinical data,clinical intervention measures and prognosis of the patients were collected,and the scores of the four scoring systems were calcu-lated.According to whether they received blood transfusion,they were divided into the blood transfusion group(34 cases)and the non-blood transfusion group(43 cases).According to whether the operation was per-formed,the surgical operation group(11 cases)and the non-surgical operation group(66 cases).According to whether rebleeding occurred during hospitalization,the rebleeding group(23 cases)and the non-rebleeding group(54 cases).The differences of each scoring system in each group were analyzed.The area under the re-ceiver operating characteristic curve was used to evaluate the predictive ability of each scoring system for blood transfusion,surgical procedure,rebleeding and ICU admission.Results There was statistically signifi-cant difference between the blood transfusion group and the non-blood transfusion group except GBS(P<0.05).There were significant differences in PRS and RS between the surgical operation group and the non-surgical operation group(P<0.05).There was no significant difference in GBS and AIMS65 scoring system between the non-surgical operation group and the non-surgical operation group(P>0.05).There were signif-icant differences in PRS,RS and GBS between the rebleeding group and the non-rebleeding group(P<0.05).There was no significant difference in AIMS65 scoring system between the non-rebleeding group and the non-rebleeding group(P>0.05).The predictive value of GBS for blood transfusion was better than that of PRS,RS and AIMS65 scoring systems,and the difference was statistically significant(P<0.05).The optimal threshold was 10 points.The predictive value of RS for surgical operation was better than that of PRS,GBS and AIMS65 scoring systems,and the differences were statistically significant(P<0.05).The optimal thresh-old was four points.The predictive value of RS for rebleeding was better than that of PRS,GBS and AIMS65AIMS65 scoring systems,and the difference was statistically significant(P<0.05).The optimal threshold was three points.There was no significant difference in the predictive value of the four scoring sys-tems for ICU admission(P>0.05).Conclusion GBS or RS should be used in the stratified treatment of AN-VUGIB patients.If GBS>10 points before gastroscopy,it is judged that the patient needs blood transfusion.After gastroscopy,if RS>4 points,the patient was judged to need surgical operation.If RS>3 points,the pa-tient will be judged to have rebleeding.
Acute non-variceal upper gastrointestinal bleedingAIMS65 scoring systemGlasgow-blatchford risk scoreRockall score before endoscopyComplete rockall score after endoscopyPredic-tive value
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