A Review of Risk Scores within Upper Gastrointestinal Bleeding

Abstract

Upper gastrointestinal bleeding is a common medical emergency. Thorough initial assessment and appropriate resuscitation are essential to stabilise the patient. Risk scores provide an important tool to discriminate between lower- and higher-risk patients. Very low-risk patients can be safely discharged for out-patient management, while higher-risk patients can receive appropriate in-patient care. The Glasgow Blatchford Score, with a score of 0–1, performs best in the identification of very low-risk patients who will not require hospital based intervention or die, and is recommended by most guidelines to facilitate safe out-patient management. The performance of risk scores in the identification of specific adverse events to define high-risk patients is less accurate, with no individual score performing consistently well. Ongoing developments in the use of machine learning models and artificial intelligence in predicting poor outcomes in UGIB appear promising and will likely form the basis of dynamic risk assessment in the future.

Validating the CHAMPS Score: A Novel and Reliable Prognostic Score of Non-Variceal Upper Gastrointestinal Bleeding

“…With regard to predicting the need for blood transfusion, the GBS score consistently outperformed other risk scores in multiple comparative studies. 8 Using a composite endpoint of the need for intervention during hospitalization, the GBS score demonstrated a moderate level of predictive efficacy in the present study (AUROC: 0.75), while fRS and AIMS65 showed limited predictive capabilities, recording AUROC values of 0.68 and 0.66, respectively. However, the CHAMPS score failed to predict this outcome.…”

“…Concerning pre-endoscopic risk scores for rebleeding, several previous studies favored the Progetto Nazionale Emorragia Digestiva (PNED) score (AUROC: 0.85–0.87) over other pre-endoscopic risk scores in predicting rebleeding. 8 , 15 In our study, the AIMS65 score exhibited good predictive ability for rebleeding (AUROC: 0.84), whereas the fRS (AUROC: 0.77) and GBS (AUROC: 0.75) scores displayed moderate predictive capabilities, and the CHAMPS score demonstrated no predictive ability for this outcome (AUROC: 0.43). Additional research is required to further investigate the application of risk scores to predict rebleeding outcomes.…”

Стратифікація Ризику Рецидиву Гастродуоденальних Виразкових Кровотеч (Огляд Літератури)

“…З поточних балів було показано, що GBS найбільш стабільно працює при ідентифікації пацієнтів із низьким ризиком, які можуть безпечно уникнути госпіталізації [31]. GBS < 1 рекомендовано більшістю сучасних рекомендацій як оптимальний поріг для ідентифікації пацієнтів, придатних для амбулаторного лікування.…”