Keywords
Upper Gastrointestinal Tract
Risk Assessment
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Abstract
Objective: To compare the efficiency of the Rockall and Glasgow-Blatchford scores in risk stratification and clinical outcome prediction for patients with upper gastrointestinal bleeding admitted to a tertiary hospital in São Paulo. Methods: This is an observational, retrospective, and quantitative study conducted with 101 individuals over a one-year period. Data collection was performed through medical record analysis. The Rockall and Glasgow-Blatchford scores were calculated for all patients included in the study. IBM SPSS Statistics software was used for ROC curve construction and calculation of areas under the ROC curves. The DeLong test was applied to compare the areas under the ROC curves. Results: The scores were equivalent in identifying low-risk patients. Glasgow-Blatchford performed better in predicting mortality and the need for blood transfusion. Neither of the scores was effective in predicting admission to the intensive care unit. Conclusion: The Rockall and Glasgow-Blatchford scores showed good performance in identifying low-risk cases, with no statistical difference between them. Both scales were effective in predicting mortality and the need for blood transfusion.
References
ABOUGERGI MS. Epidemiology of Upper Gastrointestinal Hemorrhage in the USA: Is the Bleeding Slowing Down?. Digestive Diseases and Science. 2018; 63: 1091-1093.
AKTAS G, et al. Analysis of the patients with nonvariceal upper gastrointestinal bleeding and comparison of Rockall and Glasgow-Blatchford scores. Indian Journal of Gastroenterology. 2022; 41(6): 576-582.
ALHAMMADDI N, et al. Gastrointestinal Complications Associated With Non-steroidal Anti-inflammatory Drug Use Among Adults: A Retrospective, Single-Center Study. Cureus. 2022; 14(6): e26154.
AMER ST, et al. Hemorragia digestiva e embolização arterial no Brasil: estudo sobre a distribuição e mortalidade. Revista Eletrônica Acervo Saúde. 2021; 13(10): e8990.
BITAR SM, MOUSSA M. The risk factors for the recurrent upper gastrointestinal hemorrhage among acute peptic ulcer disease patients in Syria: A prospective cohort study. Annals of Medicine and Surgery. 2022; 74: 103252.
BLATCHFORD O, et al. A risk score to predict need for treatment for uppergastrointestinal haemorrhage. The Lancet. 2000; 356(9238): 1318-1321.
CHANG A, et al. Prospective comparison of the AIMS65 score, Glasgow-Blatchford score, and Rockall score for predicting clinical outcomes in patients with variceal and nonvariceal upper gastrointestinal bleeding. Clinical endoscopy. 2021; 54(2): 211-221.
CUSTOVIC N, et al. Comparison of Glasgow-Blatchford score and Rockall score in patients with upper gastrointestinal bleeding. Medical Archives. 2020; 74(4): 270.
DORNELAS AJS, et al.. A incidência de úlcera péptica em usuários crônicos de anti-inflamatórios não esteroides. Revista Eletrônica Acervo Médico. 2023; 23(3): e12007.
DOS SANTOS FILHO SRF, et al. Fatores de risco e prevenção primária da hemorragia digestiva alta: revisão integrativa. Research, Society and Development. 2022; 11(3): e33511324681.
EL-MOHR AEMM, et al. Risk stratification of acute upper GI bleeding by Rockall, Glasgow Blatchford and aims 65 scores. Al-Azhar Medical Journal. 2020; 49(4): 1905-1918.
FAROOQ U, et al. How does cirrhosis impact mortality, morbidity, and resource utilization in non-variceal upper gastrointestinal bleeding? A nationwide analysis. Gastroenterology Review/Przegląd Gastroenterologiczny. 2022; 18(2): 204-215.
GRALNEK IM, et al. Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline–Update 2021. Endoscopy. 2021; 53(03): 300-332.
KAMBOJ AK, et al. Upper Gastrointestinal Bleeding: Etiologies and Management. Mayo Clinic Proceedings. 2019; 94(4): 697-703.
KIM MS, et al. AIMS65 scoring system is comparable to Glasgow-Blatchford score or Rockall score for prediction of clinical outcomes for non-variceal upper gastrointestinal bleeding. BMC gastroenterology. 2019; 19(1): 1-8.
LAURSEN SB, et al. Performance of new thresholds of the Glasgow Blatchford score in managing patients with upper gastrointestinal bleeding. Clinical Gastroenterology and Hepatology. 2015; 13(1): 115-121.
LU M, et al. Comparison of the Glasgow-Blatchford and Rockall Scores for prediction of nonvariceal upper gastrointestinal bleeding outcomes in Chinese patients. Medicine. 2019; 98(21): e15716.
MAIA S, et al. The clinical impact of Rockall and Glasgow-Blatchford scores in nonvariceal upper gastrointestinal bleeding. GE-Portuguese Journal of Gastroenterology. 2021; 28(4): 243-252.
MARTINS H, et al. Neto R, Velasco I. Medicina de emergência: Abordagem Prática. São Paulo: Editora Manole. 2017; 12.
MARTINS AAL, et al. Hemorragia digestiva alta, diagnóstico e tratamento: uma revisão de literatura. Pará Research Medical Journal. 2019; 3(2): e07.
MOHAMED DM e RAHMAN AARA. Glasgow-Blatchford versus Rockall Scoring Systems for Predicting Outcomes of Patients with Upper Gastrointestinal Bleeding. American Journal of Nursing. 2021; 9(6): 191-199.
NAHM FS. Receiver operating characteristic curve: overview and practical use for clinicians. Korean journal of anesthesiology. 2022; 75(1): 25-36.
OAKLAND K. Risk stratification in upper and upper and lower GI bleeding: Which scores should we use?. Best Practice & Research Clinical Gastroenterology. 2019; 42: 101613.
ORPEN-PALMER J e ADRIAN SJ, 2022. Update on the management of upper gastrointestinal bleeding. BMJ Medicine. 2022; 1(1): e000202.
PINTO C, et al., 2020. Hemorragia digestiva alta variceal y no variceal: mortalidad intrahospitalaria y características clínicas en un hospital universitario (2015-2017). Revista médica de Chile. 2020; 148(3): 288-294.
ROBERTSON M, et al. Risk stratification in acute upper GI bleeding: comparison of the AIMS65 score with the Glasgow-Blatchford and Rockall scoring systems. Gastrointestinal endoscopy. 2016; 83(6): 1151-1160.
ROCKALL T, et al. Risk assessment after acute upper gastrointestinal haemorrhage. Gut. 1996; 38(3): 316-21.
SILVA IT, et al. Acurácia da escala de glasgow blatchford para identificação de pacientes com hemorragia digestiva alta de baixo risco em um hospital privado de Florianópolis. Arquivo catarinense de medicina. 2021; 50(1): 45-57.
URBANO G e NADAI TRD. Aplicação do Glasgow-Blatchford Score (GBS) e análise de sua utilidade em prever os desfechos óbito, necessidade de hemotransfusão ou necessidade de intervenção para conter o sangramento em pacientes com Hemorragia Digestiva Alta num Centro Terciário de Emergência. 2021; 84.