Glasgow Blatchford, pre-endoscopic Rockall and AIMS65 scores show no difference in predicting rebleeding rate and mortality in variceal bleeding
| Autor: | Ivan Budimir, Marina Gradišer, Marko Nikolić, Neven Baršić, Neven Ljubičić, Dominik Kralj, Ivan Budimir jr. |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Variceal bleeding Blood transfusion Croatia medicine.medical_treatment blood transfusion esophageal and gastric varices gastrointestinal endoscopy gastrointestinal hemorrhage liver cirrhosis mortality Esophageal and Gastric Varices Risk Assessment Severity of Illness Index Gastroenterology 03 medical and health sciences 0302 clinical medicine Recurrence Internal medicine Clinical endpoint medicine Humans Upper gastrointestinal Glasgow-Blatchford score Blood Transfusion Aged Retrospective Studies business.industry Endoscopy Mean age Middle Aged Prognosis Surgery 030220 oncology & carcinogenesis Hemostasis Female 030211 gastroenterology & hepatology Gastrointestinal Hemorrhage Rockall score business |
| Zdroj: | Scandinavian Journal of Gastroenterology. 51:1375-1379 |
| ISSN: | 1502-7708 0036-5521 |
| Popis: | To compare the performance of the Glasgow Blatchford score (GBS), pre-endoscopic Rockall score (PRS) and AIMS65 score in predicting specific clinical endpoints following variceal upper gastrointestinal hemorrhage (UGIH). Material and methods: Between January 2008 and December 2013, we retrospectively analyzed 225 consecutive hospitalized patients managed for endoscopically confirmed UGIH. Results: A total of 225 patients (mean age 61.3 years), mostly diagnosed with alcoholic cirrhosis (195/86.7%), presented with variceal UGIH during the study period. Rebleeding occurred in 22 (9.8%) patients and 30-day mortality was 39 (17.3%). Initial hemostasis was achieved with N-butyl cyanoacrylate (151/79.1%) and endoscopic variceal ligation (40/20.9%), while secondary rebleeding prophylaxis in 110 (48.9%) patients was accomplished using endoscopic variceal ligation (92%). The majority of patients died from the underlying disease, while 12 (30.8%) died from bleeding. Median hospital stay was 6 (1-35) days. There was no statistically significant difference among AIMS65, GBS and PRS in predicting mortality (AUROC 0.70 vs. 0.64 vs. 0.66) or rebleeding rates (AUROC 0.74 vs. 0.60 vs. 0.67). The GBS was superior in predicting the need for blood transfusion compared to AIMS65 score (AUROC 0.75 vs. 0.61, p = 0.01) and PRS (AUROC 0.75 vs. 0.58, p = 0.009). Conclusions: The AIMS65, GBS and PRS scores are comparable but not useful for predicting outcome in patients with variceal UGIH because of poor discriminative ability. The GBS is superior in predicting the need for transfusion compared to AIMS65 score and PRS. |
| Databáze: | OpenAIRE |
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