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External validation and comparison of the Glasgow-Blatchford score, modified Glasgow-Blatchford score, Rockall score and AIMS65 score in patients with upper gastrointestinal bleeding: a cross-sectional observational study in Western Switzerland

Upper gastrointestinal bleeding (UGIB) presents a high incidence in an emergency department (ED) and requires careful evaluation of the patient’s risk level to ensure optimal management. The primary aim of this study was to externally validate and compare the performance of the Rockall score, Glasgo...

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Autores principales: Rivieri, Sirio, Carron, Pierre-Nicolas, Schoepfer, Alain, Ageron, Francois-Xavier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10405788/
https://www.ncbi.nlm.nih.gov/pubmed/36542335
http://dx.doi.org/10.1097/MEJ.0000000000000983
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author Rivieri, Sirio
Carron, Pierre-Nicolas
Schoepfer, Alain
Ageron, Francois-Xavier
author_facet Rivieri, Sirio
Carron, Pierre-Nicolas
Schoepfer, Alain
Ageron, Francois-Xavier
author_sort Rivieri, Sirio
collection PubMed
description Upper gastrointestinal bleeding (UGIB) presents a high incidence in an emergency department (ED) and requires careful evaluation of the patient’s risk level to ensure optimal management. The primary aim of this study was to externally validate and compare the performance of the Rockall score, Glasgow-Blatchford score (GBS), modified GBS and AIMS65 score to predict death and the need for an intervention among patients with UGIB. This was a cross-sectional observational study of patients consulting the ED of a Swiss tertiary care hospital with UGIB. Primary outcomes were the inhospital need for an intervention, including transfusion, or an endoscopic procedure or surgery or inhospital death. The secondary outcome was inhospital death. We included 1521 patients with UGIB, median age, 68 (52–81) years; 940 (62%) were men. Melena or hematemesis were the most common complaints in 1020 (73%) patients. Among 422 (28%) patients who needed an intervention or died, 76 (5%) died in the hospital. Accuracy of the scoring systems assessed by receiver operating characteristic curves showed that the Glasgow-Blatchford bleeding and modified GBSs had the highest discriminatory capacity to determine inhospital death or the need of an intervention [AUC, 0.77 (95% CI, 0.75–0.80) and 0.78 (95% CI, 0.76–0.81), respectively]. AIMS65 and the pre-endoscopic Rockall score showed a lower discrimination [AUC, 0.68 (95% CI, 0.66–0.71) and 0.65 (95% CI, 0.62–0.68), respectively]. For a GBS of 0, only one patient (0.8%) needed an endoscopic intervention. The modified Glasgow-Blatchford and Glasgow-Blatchford bleeding scores appear to be the most accurate scores to predict the need for intervention or inhospital death.
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spelling pubmed-104057882023-08-08 External validation and comparison of the Glasgow-Blatchford score, modified Glasgow-Blatchford score, Rockall score and AIMS65 score in patients with upper gastrointestinal bleeding: a cross-sectional observational study in Western Switzerland Rivieri, Sirio Carron, Pierre-Nicolas Schoepfer, Alain Ageron, Francois-Xavier Eur J Emerg Med Original Articles Upper gastrointestinal bleeding (UGIB) presents a high incidence in an emergency department (ED) and requires careful evaluation of the patient’s risk level to ensure optimal management. The primary aim of this study was to externally validate and compare the performance of the Rockall score, Glasgow-Blatchford score (GBS), modified GBS and AIMS65 score to predict death and the need for an intervention among patients with UGIB. This was a cross-sectional observational study of patients consulting the ED of a Swiss tertiary care hospital with UGIB. Primary outcomes were the inhospital need for an intervention, including transfusion, or an endoscopic procedure or surgery or inhospital death. The secondary outcome was inhospital death. We included 1521 patients with UGIB, median age, 68 (52–81) years; 940 (62%) were men. Melena or hematemesis were the most common complaints in 1020 (73%) patients. Among 422 (28%) patients who needed an intervention or died, 76 (5%) died in the hospital. Accuracy of the scoring systems assessed by receiver operating characteristic curves showed that the Glasgow-Blatchford bleeding and modified GBSs had the highest discriminatory capacity to determine inhospital death or the need of an intervention [AUC, 0.77 (95% CI, 0.75–0.80) and 0.78 (95% CI, 0.76–0.81), respectively]. AIMS65 and the pre-endoscopic Rockall score showed a lower discrimination [AUC, 0.68 (95% CI, 0.66–0.71) and 0.65 (95% CI, 0.62–0.68), respectively]. For a GBS of 0, only one patient (0.8%) needed an endoscopic intervention. The modified Glasgow-Blatchford and Glasgow-Blatchford bleeding scores appear to be the most accurate scores to predict the need for intervention or inhospital death. Lippincott Williams & Wilkins 2022-11-10 2023-02 /pmc/articles/PMC10405788/ /pubmed/36542335 http://dx.doi.org/10.1097/MEJ.0000000000000983 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Articles
Rivieri, Sirio
Carron, Pierre-Nicolas
Schoepfer, Alain
Ageron, Francois-Xavier
External validation and comparison of the Glasgow-Blatchford score, modified Glasgow-Blatchford score, Rockall score and AIMS65 score in patients with upper gastrointestinal bleeding: a cross-sectional observational study in Western Switzerland
title External validation and comparison of the Glasgow-Blatchford score, modified Glasgow-Blatchford score, Rockall score and AIMS65 score in patients with upper gastrointestinal bleeding: a cross-sectional observational study in Western Switzerland
title_full External validation and comparison of the Glasgow-Blatchford score, modified Glasgow-Blatchford score, Rockall score and AIMS65 score in patients with upper gastrointestinal bleeding: a cross-sectional observational study in Western Switzerland
title_fullStr External validation and comparison of the Glasgow-Blatchford score, modified Glasgow-Blatchford score, Rockall score and AIMS65 score in patients with upper gastrointestinal bleeding: a cross-sectional observational study in Western Switzerland
title_full_unstemmed External validation and comparison of the Glasgow-Blatchford score, modified Glasgow-Blatchford score, Rockall score and AIMS65 score in patients with upper gastrointestinal bleeding: a cross-sectional observational study in Western Switzerland
title_short External validation and comparison of the Glasgow-Blatchford score, modified Glasgow-Blatchford score, Rockall score and AIMS65 score in patients with upper gastrointestinal bleeding: a cross-sectional observational study in Western Switzerland
title_sort external validation and comparison of the glasgow-blatchford score, modified glasgow-blatchford score, rockall score and aims65 score in patients with upper gastrointestinal bleeding: a cross-sectional observational study in western switzerland
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10405788/
https://www.ncbi.nlm.nih.gov/pubmed/36542335
http://dx.doi.org/10.1097/MEJ.0000000000000983
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