Comparison of Risk Stratification Scores for Patients Presenting with Symptoms of Upper Gastrointestinal Bleeding in the Emergency Department

Lau, Hk; Wong, Hon Tym; Lui, CT; Tsui, Kwok Leung

doi:10.1177/102490791602300401

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…The Glasgow Blatchford Score (GBS), a well‐established risk score in UGIB has shown reliability in predicting the need for intervention 4,13,14 and is recommended in international guidelines 11,12,15 . Additionally, the score has shown to be useful in predicting mortality and length of hospital stay 4,11,14–16 . It is a composite score, which consists of biomarkers, gender, vital signs and partial baseline morbidity 17 .…”

Section: Introductionmentioning

confidence: 99%

Clinical utility of the Glasgow Blatchford Score in patients presenting to the emergency department with upper gastrointestinal bleeding: A retrospective cohort study

Ryan

Malacova

Appleyard

et al. 2021

Emerg Medicine Australasia

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Objective Upper gastrointestinal bleeding (UGIB) is a common presentation to EDs. Limited Australian data are available. Study aims were to assess mortality and re‐bleeding rates in patients presenting with UGIB as risk‐stratified by the Glasgow Blatchford Score (GBS). Methods We conducted a retrospective medical chart review of all patients presenting with UGIB to a Brisbane tertiary hospital ED over a 12‐month period. This descriptive study summarised the medical characteristics related to UGIB as risk‐stratified by the GBS. Non‐variceal bleeding was categorised as low‐risk (GBS 0–2) or high‐risk (GBS 3+). Variceal bleeding was not risk stratified. Results A total of 211 patients presented with UGIB to the ED. The median age was 57 years, 67% were male. Mortality rates at 30 days were: 0% for GBS 0–2, 3% (95% confidence interval [CI] 0–6) for GBS 3+ and 10% (95% CI 0–21) for variceal groups. The overall 30‐day re‐bleeding rate was 4.3% (95% CI 2–7). High‐risk patients accessed endoscopy according to international best practice of less than 24 h (GBS 3+, 23.7 h; variceal bleeding, 7.3 h). Conclusions Mortality and re‐bleeding outcomes are similar to other international UGIB cohorts. Patients with a low‐risk bleed were appropriately identified and discharged home. Those at higher risk were correctly identified and accessed timely endoscopy. The GBS demonstrated clinical utility in an Australian ED cohort of UGIB bleeding patients.

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Section: Introductionmentioning

confidence: 99%

Clinical utility of the Glasgow Blatchford Score in patients presenting to the emergency department with upper gastrointestinal bleeding: A retrospective cohort study

Ryan

Malacova

Appleyard

et al. 2021

Emerg Medicine Australasia

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AIMS65 Scoring System for Predicting Clinical Outcomes Among Emergency Department Patients with Upper Gastrointestinal Bleeding

Nabiel,

Munawir,

Firdaus

2024

IJAR

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Introduction: Several scoring systems were developed for early risk stratification in Upper Gastrointestinal Bleeding (UGIB) patients. AIMS65 score is a scoring system that only consists of five parameters, it might be used in daily clinical practice because of rapid and easy to calculate within 12 hours of admission. Objective: To evaluate the AIMS65 scoring system as a predictor of mortality, rebleeding events, need for endoscopic therapy, blood transfusion, and ICU admission for all causes of UGIB. Methods: We conducted a systematic review on PubMed, ScienceDirect, ProQuest, and Cochrane Library databases from the 2012 to 2022 publication period. We included either prospective or retrospective cohort studies that reported UGIB with all kinds of aetiologies who presented in the emergency department (ED), reported discriminative performance for each outcome, and reported the optimal cut-off of AIMS65. The primary measurement of discriminative performance for clinical outcomes includes mortality, rebleeding incidents, need for endoscopic therapy, blood transfusion, and ICU admission. Results: We identified 351 published studies, of which 20 were included in this study. Most of the studies reported discriminative performance for predicting mortality, which amounts to about 18 out of 20 studies. Rebleeding prediction was reported in 11 studies, need for endoscopic therapy in 5 studies, blood transfusion in 7 studies, and ICU admission in 2 studies. Most of the studies reported fair to excellent discriminative performance for predicting mortality, but in contrast for predicting rebleeding, the need for endoscopic therapy, blood transfusion, and ICU admission. Cut-off values≥ 2 are frequently reported to distinguish between high-risk and low-risk patients in mortality. Conclusion: AIMS65 can be applied to patients with UGIB in ED for predicting mortality, but not applicable for predicting rebleeding events, the need for endoscopic therapy, blood transfusion, and ICU admission. It enhances early decision-making and triage for UGIB patients.

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Comparison of Risk Stratification Scores for Patients Presenting with Symptoms of Upper Gastrointestinal Bleeding in the Emergency Department

Cited by 2 publications

References 18 publications

Clinical utility of the Glasgow Blatchford Score in patients presenting to the emergency department with upper gastrointestinal bleeding: A retrospective cohort study

Clinical utility of the Glasgow Blatchford Score in patients presenting to the emergency department with upper gastrointestinal bleeding: A retrospective cohort study

AIMS65 Scoring System for Predicting Clinical Outcomes Among Emergency Department Patients with Upper Gastrointestinal Bleeding

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