Comparison of Glasgow-Blatchford Score and Rockall Score in Patients with Upper Gastrointestinal Bleeding

Čustović, Nerma; Husić-Selimović, Azra; Srsen, N; Prohić, Džanela

doi:10.5455/medarh.2020.74.270-274

Cited by 22 publications

(17 citation statements)

References 20 publications

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“…RS predicts mortality using pre endoscopic and endoscopic finding, while GBS predicts need for blood transfusion using basic clinical and laboratory data. A high score is associated with high risk of rebleeding, needing an intervention and vice versa [20].…”

Section: Discussionmentioning

confidence: 99%

Mallory Weiss Tear - An Uncommon Cause of Upper G.I Bleeding in a Cardiac Patient with Successful Dual Intervention

Sumalatha

Fatima²,

Babu³

et al. 2023

IJMPCR

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Introduction: Primary Percutaneous Coronary Intervention (PPCI) with stenting, especially with Drug eluting stents (DES), is the most widely accepted strategy globally for patients presented with STEMI, which necessitates a long duration of Dual antiplatelet therapy (DAPT) to prevent stent thrombosis. Potent P2Y12 inhibitors for DAPT are preferred in view of their superior protection against thrombosis but at the expense of increased bleeding risks. Early therapeutic intervention in the event of acute GI bleed has beneficial outcome while on active cardiac intervention. Case Presentation: A 67-year-old patient, who underwent PPCI with DES stent, incidentally developed Mallory-Weiss (MW) tear, which manifested as severe hematemesis when loaded with DAPT consisting of Aspirin and Ticagrelor. The therapy was withheld until the clipping of the tear was done. Single antiplatelet therapy (SAPT) with Aspirin was reinstituted after a day and DAPT with Aspirin plus Clopidogrel after a week. Conclusion: A careful assessment of the risks and benefits of acute coronary interventions need to consider complications and timely interventions thus individualizing and curating the DAPT as deemed necessary.

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Section: Discussionmentioning

confidence: 99%

Mallory Weiss Tear - An Uncommon Cause of Upper G.I Bleeding in a Cardiac Patient with Successful Dual Intervention

Sumalatha

Fatima²,

Babu³

et al. 2023

IJMPCR

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“…A systematic review published in 2016 which included 16 studies found that GBS score was more accurate for both intervention and 30-day mortality than Rockall score and AIM65 [ 30 ]; another study found that the accuracy of GBS for predicting mortality was poor [ 31 ], and in a study of NVUGIB, pre-endoscopic and full RS were superior to GBS in predicting in-hospital mortality (AUC 0.842 for pre-RS, 0.804 for full-RS and 0.622 for GBS) [ 25 ]. In a study of 237 patients with both variceal and non-variceal UGIB, RS was superior to GBS [ 26 ]. A study which analyzed in-hospital mortality found that AIM65 was better than both GBS and full Rockall score in predicting mortality (AUC 0.955), regardless of variceal or non-variceal bleeding [ 24 ], while another study found that the accuracy of AIM65 was better than that of GBS for predicting 30-day mortality (AUC 0.706 versus 0.542) [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the patients with no endoscopy performed represent a heterogenous group, with few studies regarding both mortality and the role of risk (non-endoscopic) scores in the prognostic evaluation. The mortality risk in the subgroup of patients without endoscopy is poorly evaluated in the literature; most studies included only patients with UGIB with endoscopy performed, and the absence of endoscopy represents one of the exclusion criteria in studies evaluating the performance of risk scores [ 1 , 3 , 4 , 10 , 24 , 25 , 26 , 27 ]. In this setting, a study evaluating the accuracy of prognostic scores for mortality in a subgroup of patients without endoscopy and with no known etiology for bleeding can be useful in order to predict the risk of death.…”

Section: Introductionmentioning

confidence: 99%

The Accuracy of Pre-Endoscopic Scores for Mortality Prediction in Patients with Upper GI Bleeding and No Endoscopy Performed

Cazacu

Alexandru

Statie³

et al. 2023

Diagnostics

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(1) Background: The assessment of mortality and rebleeding rate in upper gastrointestinal bleeding (UGIB) is essential, and several prognostic scores have been proposed. Some patients with UGIB did not undergo endoscopy, either because they refused the procedure, suffered from alcohol withdrawal symptoms or altered general status, or because the bleeding was severe enough to cause death before the endoscopy. The mortality risk in the subgroup of patients without endoscopy is poorly evaluated in the literature. (2) Methods: The purpose of the study was to identify the most useful scores for the assessment of in-hospital mortality in patients with UGIB with no endoscopy performed and no known etiology. A total of 198 patients with UGIB and no endoscopy performed were admitted between January 2017 and December 2021 and the accuracy of 12 prognostic scores and the Charlson comorbidity index for in-hospital mortality prediction were analyzed, as well as Child–Pugh Turcotte (CPT) and Meld scores in patients with cirrhosis. (3) Results: The mortality rate was 37.9%, higher than in variceal (21.9%, p < 0.0001) and non-variceal bleeding (7.4%, p < 0.0001). The most accurate scores by AUC were the International Bleeding score (INBS, 0.844), Glasgow Blatchford (0.783), MAP score (0.78), Iino (0.766), AIM65 and modified N-score (0.745 each), modified Glasgow-Blatchford (0.73), H3B2 and N-score (0.701); Rockall, Baylor, and T-score had an AUC below 0.7. MELD score was superior to CPT in patients with cirrhosis (AUC 0.811 versus 0.670). (4) Conclusions: The mortality rate in UGIB with no endoscopy was higher than in both variceal and non-variceal bleeding and was higher in the pandemic period but with no statistical significance (45.3% versus 32.14%, p = 0.0586), mainly because of positive cases. Only one case of rebleeding was noted; the hospitalization period was significantly shorter. The most accurate score was International Bleeding Score; the MELD score had a higher but moderate accuracy compared with CPT in patients with cirrhosis.

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“…The Rockall score, which includes both pre-and post-endoscopic components, has a high predictive capability for mortality [ 17 ]. However, because it requires several components, the Rockall score may be challenging to use in the ED [ 18 ]. The AIMS65 score was also identified as a good predictive factor for long-term hospitalization and in-hospital mortality.…”

Section: Discussionmentioning

confidence: 99%

International Normalized Ratio-to-Albumin Ratio as a Novel Marker of Upper Gastrointestinal Bleeding Severity

Choi

Lee

et al. 2022

Gastroenterology Research and Practice

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Introduction. Upper gastrointestinal bleeding (UGIB) is a potentially life-threatening gastrointestinal emergency, and effective management depends on early risk stratification. The Glasgow–Blatchford and Rockall scores are commonly used prognostic measures for UGIB, although these scoring systems are relatively difficult to apply in early emergency settings. AIMS65 with five items, albumin, international normalized ratio, mental status, systolic blood pressure, and age (>65 years), showed efficacy in predicting long-term hospitalization and mortality. This study aimed to investigate the usefulness of the prothrombin time-international normalized ratio-to-albumin ratio (PTAR) in the emergency room for early UGIB risk stratification. Methods. We retrospectively examined patients who visited a tertiary academic hospital’s emergency department (ED) with UGIB as the chief presentation between January 2019 and December 2020. The cutoff values and diagnostic accuracies of the PTAR, Glasgow–Blatchford score, AIMS65 score, pre-endoscopy, and complete Rockall score were analyzed, and the performance of the PTAR was compared with that of other risk stratification methods. In total, 519 patients were enrolled: 163 patients were admitted in the intensive care unit (ICU) and 35 died during admission. Multiple logistic regression analyses confirmed the association of the PTAR with ICU admission and mortality. The adjusted odd ratio (aOR) of the PTAR for ICU admission care was 8.376 (2.722–25.774), and the aOR of the PTAR for mortality was 27.846 (8.701–89.116). Conclusions. The PTAR measured in the ED is an independent factor related to ICU admission and mortality in patients with UGIB. Using ED blood laboratory results, which are reported relatively quickly and are easy to acquire and calculate, the PTAR can be used as a risk stratification marker in the early emergency setting.

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Comparison of Glasgow-Blatchford Score and Rockall Score in Patients with Upper Gastrointestinal Bleeding

Cited by 22 publications

References 20 publications

Mallory Weiss Tear - An Uncommon Cause of Upper G.I Bleeding in a Cardiac Patient with Successful Dual Intervention

Mallory Weiss Tear - An Uncommon Cause of Upper G.I Bleeding in a Cardiac Patient with Successful Dual Intervention

The Accuracy of Pre-Endoscopic Scores for Mortality Prediction in Patients with Upper GI Bleeding and No Endoscopy Performed

International Normalized Ratio-to-Albumin Ratio as a Novel Marker of Upper Gastrointestinal Bleeding Severity

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