Bozkurt Seyran, Köse Ataman, Arslan Engin Deniz, Erdoğan Semra, Üçbilek Enver, Çevik İbrahim, Ayrık Cüneyt, Sezgin Orhan
Emergency Medicine Department, Mersin University Medical Faculty, Mersin, Turkey.
Department of Emergency Medicine, Diskapı Yıldırım Beyazit Training and Research Hospital, Ankara, Turkey.
Scand J Trauma Resusc Emerg Med. 2015 Dec 30;23:109. doi: 10.1186/s13049-015-0194-z.
GBS, MEWS, and PER scoring systems are not commonly used for patients presenting to emergency department with GIS bleeding. This study aimed to determine the value of MEWS, GBS, and PER scores in predicting bleeding at follow-up, endoscopic therapy and blood transfusion need, mortality, and rebleeding within a 1-month period.
A total of 202 consecutive patients with upper GIS bleeding between July 2013 and November 2014 were prospectively enrolled in the study. The relationship between MEWS, GBS, and PER scores and hospital outcome, bleeding at follow-up, endoscopic therapy, transfusion need, rebleeding, and death were examined.
The study included a total of 202 subjects, with 84 (41.6 %) females and 118 (58.4 %) males. There was a significant correlation between GBS, MEWS, and PER scores and hospital outcomes (p <0.004, p <0.001, p <0.001, respectively). A GBS score greater than 11 succesfully predicted bleeding at follow-up (p = 0.0237). GBS score's sensitivity for predicting endoscopic therapy was greater than those of other scoring systems. The discriminatory power of each scoring system was significant for predicting transfusion (p <0.0001, p = 0.0470, and p = 0.0014, respectively). A GBS score greater than 13, a MEWS score greater than 2, and a PER score greater than 3 predicted death. A PER score greater than 3 predicted rebleeding (p <0.0001).
The scoring systems in question can be easily calculated in patients presenting to ED with upper GIS bleeding and may be beneficial for risk stratification, determination of transfusion need, prediction of rebleeding, and decisions of hospitalization or discharge.
格拉斯哥-布利奇评分（GBS）、改良早期预警评分（MEWS）和患者急诊室风险评分（PER）系统在因胃肠道（GIS）出血就诊于急诊科的患者中并不常用。本研究旨在确定MEWS、GBS和PER评分在预测随访时出血、内镜治疗和输血需求、死亡率以及1个月内再出血方面的价值。
2013年7月至2014年11月期间，共有202例连续的上消化道GIS出血患者前瞻性纳入本研究。研究了MEWS、GBS和PER评分与医院结局、随访时出血、内镜治疗、输血需求、再出血和死亡之间的关系。
本研究共纳入202名受试者，其中女性84名（41.6%），男性118名（58.4%）。GBS、MEWS和PER评分与医院结局之间存在显著相关性（分别为p<0.004、p<0.001、p<0.001）。GBS评分大于11成功预测了随访时的出血（p=0.0237）。GBS评分预测内镜治疗的敏感性高于其他评分系统。每个评分系统在预测输血方面的鉴别能力均具有显著性（分别为p<0.0001、p=0.0470和p=0.0014）。GBS评分大于13、MEWS评分大于2和PER评分大于3预测死亡。PER评分大于3预测再出血（p<0.0001）。
所讨论的评分系统在因上消化道GIS出血就诊于急诊科的患者中易于计算，可能有助于风险分层、确定输血需求、预测再出血以及决定住院或出院。
