Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
Medicine (Baltimore). 2022 Sep 9;101(36):e30410. doi: 10.1097/MD.0000000000030410.
Few studies have focused on assessing the usefulness of scoring systems such as the Rockall score (RS), Glasgow-Blatchford score (GBS), and AIMS65 score for risk stratification and prognosis prediction in peptic ulcer bleeding patients. This study aimed to assess scoring systems in predicting clinical outcomes of patients with peptic ulcer bleeding. A total of 682 peptic ulcer bleeding patients who underwent esophagogastroduodenoscopy between January 2013 and December 2017 were found eligible for this study. The area under the receiver-operating characteristic curve (AUROC) of each score was calculated for predicting rebleeding, hospitalization, blood transfusion, and mortality. The median age of patients was 64 (interquartile range, 56-75) years. Of the patients, 74.9% were men, and 373 underwent endoscopic intervention. The median RS, GBS, and AIMS65 scores were significantly higher in patients who underwent endoscopic intervention than in those who did not. The AUROC of RS for predicting rebleeding was significantly higher than that of GBS (P = .022) or AIMS65 (P < .001). GBS best predicted the need for blood transfusion than either pre-RS (P = .013) or AIMS65 (P = .001). AIMS65 score showed the highest AUROC for mortality (0.652 vs. 0.622 vs. 0.691). RS was significantly associated with rebleeding (odds ratio, 1.430; P < .001) and overall survival (hazard ratio, 1.217; P < .001). The RS, GBS, and AIMS65 scoring systems are acceptable tools for predicting clinical outcomes in peptic ulcer bleeding. RS is an independent prognostic factor of rebleeding and overall survival.
很少有研究关注评估评分系统（如 Rockall 评分[RS]、格拉斯哥-布拉奇福德评分[GBS]和 AIMS65 评分）在预测消化性溃疡出血患者风险分层和预后方面的有用性。本研究旨在评估评分系统在预测消化性溃疡出血患者临床结局中的作用。共纳入 2013 年 1 月至 2017 年 12 月间接受内镜检查的 682 例消化性溃疡出血患者。计算每个评分系统预测再出血、住院、输血和死亡的受试者工作特征曲线下面积（AUROC）。内镜干预的患者的 RS、GBS 和 AIMS65 评分中位数明显高于未行内镜干预的患者。RS 预测再出血的 AUROC 明显高于 GBS（P =.022）或 AIMS65（P <.001）。GBS 预测输血需求的最佳指标，优于 RS（P =.013）或 AIMS65（P =.001）。AIMS65 评分预测死亡率的 AUROC 最高（0.652 比 0.622 比 0.691）。RS 与再出血（优势比，1.430；P <.001）和总生存（风险比，1.217；P <.001）显著相关。RS、GBS 和 AIMS65 评分系统是预测消化性溃疡出血患者临床结局的有效工具。RS 是再出血和总生存的独立预后因素。
