Thanapirom Kessarin, Ridtitid Wiriyaporn, Rerknimitr Rungsun, Thungsuk Rattikorn, Noophun Phadet, Wongjitrat Chatchawan, Luangjaru Somchai, Vedkijkul Padet, Lertkupinit Comson, Poonsab Swangphong, Ratanachu-ek Thawee, Hansomburana Piyathida, Pornthisarn Bubpha, Thongbai Thirada, Mahachai Varocha, Treeprasertsuk Sombat
Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Division of Gastroenterology, Sawanpracharak Hospital, Nakhon Sawan, Thailand.
J Gastroenterol Hepatol. 2016 Apr;31(4):761-7. doi: 10.1111/jgh.13222.
Data regarding the efficacy of the Glasgow Blatchford score (GBS), full Rockall score (FRS) and pre-endoscopic Rockall scores (PRS) in comparing non-variceal and variceal upper gastrointestinal bleeding (UGIB) are limited. Our aim was to determine the performance of these three risk scores in predicting the need for treatment, mortality, and re-bleeding among patients with non-variceal and variceal UGIB.
During January, 2010 and September, 2011, patients with UGIB from 11 hospitals were prospectively enrolled. The GBS, FRS, and PRS were calculated. Discriminative ability for each score was assessed using the receiver operated characteristics curve (ROC) analysis.
A total of 981 patients presented with acute UGIB, 225 patients (22.9%) had variceal UGIB. The areas under the ROC (AUC) of the GBS, FRS, and PRS for predicting the need for treatment were 0.77, 0.69, and 0.61 in non-variceal versus 0.66, 0.66, and 0.59 in variceal UGIB. The AUC for predicting mortality and re-bleeding during admission were 0.66, 0.80, and 0.76 in non-variceal versus 0.63, 0.57, and 0.63 in variceal UGIB. AUC score was not statistically significant for predicting need for therapy and clinical outcome in variceal UGIB. The GBS ≤ 2 and FRS ≤ 1 identified low-risk non-variceal UGIB patients for death and re-bleeding during hospitalization.
In contrast to non-variceal UGIB, the GBS, FRS, and PRS were not precise scores for assessing the need for therapy, mortality, and re-bleeding during admission in variceal UGIB.
关于格拉斯哥布拉奇福德评分（GBS）、完整罗卡尔评分（FRS）和内镜检查前罗卡尔评分（PRS）在比较非静脉曲张性和静脉曲张性上消化道出血（UGIB）疗效方面的数据有限。我们的目的是确定这三种风险评分在预测非静脉曲张性和静脉曲张性UGIB患者的治疗需求、死亡率和再出血方面的表现。
在2010年1月至2011年9月期间，前瞻性纳入了11家医院的UGIB患者。计算GBS、FRS和PRS。使用受试者操作特征曲线（ROC）分析评估每个评分的判别能力。
共有981例患者出现急性UGIB，225例患者（22.9%）为静脉曲张性UGIB。GBS、FRS和PRS预测非静脉曲张性UGIB治疗需求的ROC曲线下面积（AUC）分别为0.77、0.69和0.61，而静脉曲张性UGIB分别为0.66、0.66和0.59。预测非静脉曲张性UGIB住院期间死亡率和再出血的AUC分别为0.66、0.80和0.76，而静脉曲张性UGIB分别为0.63、0.57和0.63。AUC评分在预测静脉曲张性UGIB的治疗需求和临床结局方面无统计学意义。GBS≤2和FRS≤1可识别出非静脉曲张性UGIB低风险患者住院期间的死亡和再出血情况。
与非静脉曲张性UGIB不同，GBS、FRS和PRS并非评估静脉曲张性UGIB住院期间治疗需求、死亡率和再出血的精确评分。
