Comparison of prediction of outcomes in upper GI bleed using non-endoscopic scoring systems

Nagaraja, BS; Vinay, K; Rao, K Akhila; Umesh, K J; Prashant, B.

doi:10.18203/2349-3933.ijam20182391

Cited by 4 publications

(1 citation statement)

References 18 publications

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“…Furthermore, recognizing elderly patients with UGIB who are at minimum risk for adverse outcomes means they can be discharged earlier and in safer conditions, leading to a reduction in health, social, and economic costs. [12] The Charlson comorbidity index (CCI) is a reliable method of measuring comorbidity based on a history of concomitant diseases such as tumoral disorders, renal failure, cerebrovascular disease, coronary artery disease, peripheral vascular disease, liver disease, renal failure hemiplegia, diabetes mellitus, ulcer disease, and acquired immunodeficiency syndrome (AIDS). [13][14][15][16] It is a method of predicting mortality by classifying or weighting these comorbid disease conditions and has been utilized by healthcare providers to estimate the severity of the disease and case mix.…”

Section: Introductionmentioning

confidence: 99%

Prediction of Adverse Outcomes using Non-Endoscopic Scoring Systems in Patients Over 80 Years of Age Who Present With Upper Gastrointestinal Bleeding in the Emergency Department

Bardakçı¹

2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:The emergency department (ED) admission rate for elderly patients with non-variceal upper gastrointestinal bleeding (UGIB) is increasing. The AIMS65 and Glasgow-Blatchford score (GBS) are two distinct scoring systems proposed to predict in-hospital and post-discharge mortality, length of stay (LOS), and health-related costs in these patients. The objective of the present study is to evaluate the accuracy of these scoring systems, in conjunction with the Charlson comorbidity index (CCI), to predict 30-day mortality and LOS in UGIB patients who are 80 years of age or older METHODS: A retrospective analysis was undertaken of 182 patients with non-variceal UGIB who were admitted to the ED of Canakkale Onsekiz Mart University Hospital. The AIMS65, GBS, and CCI scores were calculated and adverse patient outcomes were assessed. RESULTS:The mean age of patients was 85.59±4.33 years, and 90 (49.5%) of the patients were males. The AIMS65 was superior to the GBS (area under the receiver operating characteristic curve [AUROC] 0.877 vs. 0.695, respectively) and CCI (AUROC 0.877 vs. 0.526, respectively) in predicting the 30-day mortality. All three scores performed poorly in predicting the LOS in hospital. The cutoff threshold that maximized sensitivity and specificity for mortality was three for the AIMS65 score (

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Section: Introductionmentioning

confidence: 99%

Prediction of Adverse Outcomes using Non-Endoscopic Scoring Systems in Patients Over 80 Years of Age Who Present With Upper Gastrointestinal Bleeding in the Emergency Department

Bardakçı¹

2020

Ulus Travma Acil Cerrahi Derg

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Utility of the CANUKA Scoring System in the Risk Assessment of Upper GI Bleeding

Goff

Friedman

Toro

et al. 2022

Journal of Clinical Gastroenterology

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Background: The Canada-United Kingdom-Adelaide (CANUKA) score was developed to stratify patients who experience upper gastrointestinal bleeding (UGIB) to predict who could be discharged from the emergency department. Our aim was to determine if the CANUKA score could be utilized for UGIB in-patients undergoing endoscopy in predicting adverse outcomes. We additionally sought to establish a CANUKA score cut point to predict adverse outcomes and in-hospital mortality and compare this to established scoring systems.Methods: Between January 1, 2018 to June 30, 2019 all patients who underwent upper endoscopy after admission for UGIB were identified. We assigned a CANUKA score and compared the area under the receiver operating curve to established scoring systems.Results: Our data set included 641 patients, with a mean age of 59.5 ± 14.5 years. A CANUKA score ≥ 10 was associated with an adverse outcome [unadjusted odds ratio, 3.08 (1.79, 5.27)]. No patients experienced an adverse outcome with a CANUKA score <4. No patients died with a CANUKA score <6. Those with a CANUKA score of <10 had an in-hospital mortality of 2.1% compared with 6.8% for those with a score ≥ 10 (P = 0.008). AIMS65 had the best area under the receiver operating characteristic curve (0.809) for predicting mortality. Conclusions:The CANUKA score may serve utility as a predictor of adverse outcomes and mortality in patients admitted with UGIB undergoing endoscopy. Future studies, ideally prospective and multicenter, will be needed to validate its clinical utility.

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Comparison of Non-Endoscopic Scores for the Prediction of Outcomes in Patients of Upper Gastrointestinal Bleed in an Emergency of a Tertiary Care Referral Hospital: A Prospective Cohort Study

Sachan

Dhibar

Bhalla

et al. 2021

Arq. Gastroenterol.

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BACKGROUND: Traditionally peptic ulcer disease was the most common cause of upper gastrointestinal (UGI) bleed but with the changing epidemiology; other etiologies of UGI bleed are emerging. Many scores have been described for predicting outcomes and the need for intervention in UGI bleed but prospective comparison among them is scarce. OBJECTIVE: This study was planned to determine the etiological pattern of UGI bleed and to compare Glasgow Blatchford score, Pre-Endoscopy Rockall score, AIMS65, and Modified Early Warning Score (MEWS) as predictors of outcome. METHODS: In this prospective cohort study 268 patients of UGI bleed were enrolled and followed up for 8 weeks. Glasgow Blatchford score, Endoscopy Rockall score, AIMS65, and MEWS were calculated for each patient, and the area under the receiver operating characteristic (AUC-ROC) curve for each score was compared. RESULTS: The most common etiology for UGI bleed were gastroesophageal varices 150 (63.55%) followed by peptic ulcer disease 29 (12.28%) and mucosal erosive disease 27 (11.44%). Total 38 (15.26%) patients had re-bleed and 71 (28.5%) patients died. Overall, 126 (47%) patients required blood component transfusion, 25 (9.3%) patients required mechanical ventilation and 2 (0.74%) patients required surgical intervention. Glasgow Blatchford score was the best in predicting the need for transfusion (cut off - 10, AUC-ROC= 0.678). Whereas AIMS65 with a score of ≥2 was best in predicting re-bleed (AUC-ROC=0.626) and mortality (AUC-ROC=0.725). CONCLUSION: Gastrointestinal bleed was most commonly of variceal origin at our tertiary referral center in Northern India. AIMS65 was the best & simplest score with a score of ≥2 for predicting re-bleed and mortality.

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Comparison of prediction of outcomes in upper GI bleed using non-endoscopic scoring systems

Cited by 4 publications

References 18 publications

Prediction of Adverse Outcomes using Non-Endoscopic Scoring Systems in Patients Over 80 Years of Age Who Present With Upper Gastrointestinal Bleeding in the Emergency Department

Prediction of Adverse Outcomes using Non-Endoscopic Scoring Systems in Patients Over 80 Years of Age Who Present With Upper Gastrointestinal Bleeding in the Emergency Department

Utility of the CANUKA Scoring System in the Risk Assessment of Upper GI Bleeding

Comparison of Non-Endoscopic Scores for the Prediction of Outcomes in Patients of Upper Gastrointestinal Bleed in an Emergency of a Tertiary Care Referral Hospital: A Prospective Cohort Study

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