Choi Seong Woo, Moon Hee Seok, Kwon In Sun, Sakong Heon, Kang Sun Hyung, Sung Jae Kyu, Jeong Hyun Yong
Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea.
Clinical Trials Center, Chungnam National University Hospital, Daejeon, Republic of Korea.
Dig Dis. 2023;41(1):66-73. doi: 10.1159/000526136. Epub 2022 Jul 28.
Various scoring systems have been developed to predict endoscopic intervention, mortality, and rebleeding in patients with nonvariceal upper gastrointestinal bleeding (NVUGIB); however, they have not been sufficiently validated in Korea. Therefore, this study aimed to evaluate the usefulness of several scoring systems in Korea by validating and comparing the Japanese score and other scores in Korean people with NVUGIB.
The medical records of 1,368 patients with NVUGIB were reviewed to collect statistical, clinical, laboratory, and endoscopic data. The Japanese score, ABC score, Glasgow-Blatchford Bleeding Score (GBS), and MAP score were calculated retrospectively at a single research institution. These scores for predicting the need for endoscopic intervention, mortality, and rebleeding were calculated and evaluated using the area under the receiver operating characteristic curve.
Of 1,368 patients, 88.5% required endoscopic intervention, 4.1% died within 30 days, and 12.6% experienced rebleeding. The Japanese score was effective for predicting endoscopic intervention, and the ABC score was best for predicting 30-day mortality. Sex, age, hematemesis, blood urea nitrogen, and American Society of Anesthesiologists score were found to be predictors of the need for endoscopic intervention.
The Japanese score did not prove useful in Koreans with upper gastrointestinal bleeding. Additional research is needed due to the limitations of a retrospective study conducted in a single research institute.
已经开发了各种评分系统来预测非静脉曲张性上消化道出血（NVUGIB）患者的内镜干预、死亡率和再出血情况；然而，这些评分系统在韩国尚未得到充分验证。因此，本研究旨在通过在韩国NVUGIB患者中验证和比较日本评分及其他评分，评估几种评分系统在韩国的实用性。
回顾了1368例NVUGIB患者的病历，以收集统计、临床、实验室和内镜数据。在单一研究机构对日本评分、ABC评分、格拉斯哥-布拉奇福德出血评分（GBS）和MAP评分进行回顾性计算。使用受试者工作特征曲线下面积计算并评估这些用于预测内镜干预需求、死亡率和再出血的评分。
1368例患者中，88.5%需要内镜干预，4.1%在30天内死亡，12.6%发生再出血。日本评分对预测内镜干预有效，ABC评分对预测30天死亡率最佳。发现性别、年龄、呕血、血尿素氮和美国麻醉医师协会评分是内镜干预需求的预测因素。
日本评分在韩国上消化道出血患者中未被证明有用。由于在单一研究机构进行的回顾性研究存在局限性，需要进一步研究。
