Department of Gastroenterology, Kaiser Permanente, Los Angeles, CA 90027, USA.
Aliment Pharmacol Ther. 2012 Oct;36(8):782-9. doi: 10.1111/apt.12029. Epub 2012 Aug 28.
Several risk scoring systems exist for upper gastrointestinal bleed (UGIB). We hypothesised that a modified Glasgow Blatchford Score (mGBS) that eliminates the subjective components of the GBS might perform as well as current scoring systems.
To compare the performance of the mGBS to the most widely reported scoring systems for prediction of clinical outcomes in patients presenting with UGIB.
Prospective cohort study from 9/2010 to 9/2011. Accuracy of the mGBS was compared with the full GBS, full Rockall Score (RS) and clinical RS using area under the receiver operating characterstics-curve (AUC). PRIMARY OUTCOME was need for clinical intervention: blood transfusion, endoscopic, radiological or surgical intervention. Secondary outcome was repeat bleeding or mortality.
One hundred and ninety-nine patients were included. Median age was 56 with 40% women. Thirty-two per cent patients required blood transfusion, 24% endoscopic interventions, 0.5% radiological intervention, 0 surgical interventions, 5% had repeat bleeding and 0.5% mortality.
the mGBS (AUC 0.85) performed as well as the GBS (AUC = 0.86, P = 0.81), and outperformed the full RS (AUC 0.75, P = 0.005) and clinical RS (AUC 0.66, P < 0.0001). Secondary outcome: the mGBS (AUC 0.83) performed as well as the GBS (AUC 0.81, P = 0.38) and full RS (AUC 0.69, and outperformed the clinical RS (AUC 0.59, P = 0.0007).
The modified Glasgow Blatchford Score performed as well as the full Glasgow Blatchford Score while outperforming both Rockall Scores for prediction of clinical outcomes in American patients with upper gastrointestinal bleed. By eliminating the subjective components of the Glasgow Blatchford Score, the modified Glasgow Blatchford Score may be easier to use and therefore more easily implemented into routine clinical practice.
有几种用于上消化道出血 (UGIB) 的风险评分系统。我们假设一种改良的格拉斯哥布莱特福德评分 (mGBS)，它消除了 GBS 的主观成分，其表现可能与当前的评分系统一样好。
比较 mGBS 与最广泛报道的评分系统在预测 UGIB 患者临床结局方面的表现。
前瞻性队列研究，时间为 2010 年 9 月至 2011 年 9 月。使用受试者工作特征曲线下面积 (AUC) 比较 mGBS 与完整 GBS、完整 Rockall 评分 (RS) 和临床 RS 的准确性。主要结局是需要临床干预：输血、内镜、放射或手术干预。次要结局是再次出血或死亡。
共纳入 199 例患者。中位年龄为 56 岁，女性占 40%。32%的患者需要输血，24%需要内镜干预，0.5%需要放射干预，0 例需要手术干预，5%出现再次出血，0.5%死亡。
mGBS（AUC 0.85）与 GBS（AUC = 0.86，P = 0.81）表现相当，优于完整 RS（AUC 0.75，P = 0.005）和临床 RS（AUC 0.66，P < 0.0001）。次要结局：mGBS（AUC 0.83）与 GBS（AUC 0.81，P = 0.38）表现相当，优于完整 RS（AUC 0.69），优于临床 RS（AUC 0.59，P = 0.0007）。
改良格拉斯哥布莱特福德评分与完整格拉斯哥布莱特福德评分表现相当，优于两种 Rockall 评分，可预测美国上消化道出血患者的临床结局。通过消除格拉斯哥布莱特福德评分的主观成分，改良格拉斯哥布莱特福德评分可能更容易使用，因此更容易纳入常规临床实践。
