Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
Gut Liver. 2017 Nov 15;11(6):813-820. doi: 10.5009/gnl16607.
BACKGROUND/AIMS: Various clinical scoring systems, including the Glasgow-Blatchford score (GBS), Rockall risk score (RS), and AIMS65 score (AIMS65), have been validated to predict the clinical outcomes in patients with upper gastrointestinal bleeding (UGIB). We compared the performance of these three scoring systems in predicting clinical outcomes in patients with UGIB in Korea.
We retrospectively evaluated 286 patients with UGIB who visited emergency department. The primary outcome was the need for clinical intervention (endoscopic, radiologic, or surgical) and blood transfusion.
The causes of UGIB were esophageal/gastric varices in 64 patients, peptic ulcer in 168, Mallory-Weiss tear in 32, malignancy of UGI tract in eight, and unknown in 14. One hundred seventy-four (61%) patients required blood transfusion, 166 (58%) required endoscopic intervention, and 10 (3.5%) required surgical intervention. The GBS outperformed the RS and AIMS65 in predicting the need for endoscopic intervention.
The GBS and RS were more accurate than AIMS65 in predicting the need for clinical interventions and transfusion patients with UGIB, regardless of variceal or nonvariceal bleeding. The AIMS65 may not be optimal for predicting clinical outcomes of UGIB in Korea.
背景/目的:多种临床评分系统,包括格拉斯哥-布拉奇福德评分(GBS)、罗克厄尔风险评分(RS)和 AIMS65 评分(AIMS65),已被验证可预测上消化道出血(UGIB)患者的临床结局。我们比较了这三种评分系统在预测韩国 UGIB 患者临床结局方面的表现。
我们回顾性评估了 286 例因 UGIB 就诊急诊的患者。主要结局是临床干预(内镜、放射或手术)和输血的需求。
UGIB 的病因包括食管/胃静脉曲张 64 例,消化性溃疡 168 例,Mallory-Weiss 撕裂 32 例,上消化道恶性肿瘤 8 例,不明原因 14 例。174 例(61%)患者需要输血,166 例(58%)需要内镜干预,10 例(3.5%)需要手术干预。GBS 在预测内镜干预需求方面优于 RS 和 AIMS65。
GBS 和 RS 比 AIMS65 更能准确预测 UGIB 患者是否需要临床干预和输血,无论出血是静脉曲张性还是非静脉曲张性。AIMS65 可能不适合预测韩国 UGIB 的临床结局。