Validation and Comparison of the Japanese Score and Other Scores in Patients with Nonvariceal Upper Gastrointestinal Bleeding: A Retrospective Study

Abstract

Background: Various scoring systems have been developed to predict endoscopic intervention, mortality, and rebleeding in patients with non-variceal upper gastrointestinal bleeding (NVUGIB); however, they have not been sufficiently validated in Korea. Therefore, this study aimed to evaluate the usefulness of several scoring systems in Korea by validating and comparing the Japanese score and other scores in Korean people with NVUGIB. Methods: The medical records of 1368 patients with NVUGIB were reviewed to collect statistical, clinical, laboratory, and endoscopic data. The Japanese score, ABC score, Glasgow-Blatchford Bleeding Score (GBS), and MAP score were calculated retrospectively at a single research institution. These scores for predicting the need for endoscopic intervention, mortality, and rebleeding were calculated and evaluated using the area under the receiver operating characteristic curve. Results: Of 1368 patients, 88.5% required endoscopic intervention, 4.1% died within 30 days, and 12.6% experienced rebleeding. The Japanese score was effective for predicting endoscopic intervention, and the ABC score was best for predicting 30-day mortality. Sex, age, hematemesis, blood urea nitrogen, and American Society of Anesthesiologists score were found to be predictors of the need for endoscopic intervention. Conclusion: The Japanese score did not prove useful in Koreans with upper gastrointestinal bleeding. Additional research is needed due to the limitations of a retrospective study conducted in a single research institute.

Comparison and validation of the Japanese score and other scoring systems in patients with peptic ulcer bleeding: A retrospective study

“…[5] A previous study in South Korea demonstrated the superiority of the Japanese score in predicting the need for endoscopic intervention for patients with UGIB, except in patients with NVUGIB. [6] In this study, when the patient group was limited to those with PUB, the Japanese score showed superior predictive ability for the need for endoscopic intervention (AUC value: .724, P < .001) when compared with other scoring systems, including the GBS (AUC value: .587, P = .002). Compared with that observed in Choi study, the AUC value of the Japanese score for predicting the need for endoscopic intervention in patients with PUB was higher than that in patients with NVUGIB (AUC value: .699, P < .001).…”

“…[ 5 ] A previous study in South Korea demonstrated the superiority of the Japanese score in predicting the need for endoscopic intervention for patients with UGIB, except in patients with NVUGIB. [ 6 ]…”

“…Compared with that observed in Choi study, the AUC value of the Japanese score for predicting the need for endoscopic intervention in patients with PUB was higher than that in patients with NVUGIB (AUC value: .699, P < .001). [ 6 ] Direct comparison of the 2 values is difficult, and whether the increased AUC value is statistically significant is unknown because the values were not calculated in the same patient group; however, the pathogenesis of peptic ulcers, among other variables contributing to the Japanese score, may be related to the overall increase in the AUC value of the Japanese score when limited to predicting the need for intervention for patients with peptic ulcers.…”

“…Recently, a few studies have compared the Japanese score with other scoring systems and verified the effectiveness of the Japanese score in patients with UGIB. Choi et al [ 6 ] performed a retrospective study that compared the Japanese score with other scoring systems in patients with non-variceal upper gastrointestinal bleeding (NVUGIB) and found that compared to other scoring systems, the Japanese score was more effective in predicting endoscopic intervention but showed no superiority in predicting 30-day mortality or rebleeding. Therefore, this study aimed to determine whether the Japanese score is superior to other validated systems [age, blood test, and comorbidities (ABC) score; mental status, American Society of Anesthesiologists (ASA) score, and pulse rate (MAP); and Glasgow–Blatchford score (GBS)] in predicting clinical outcomes among patients with NUVGIB due to PUB.…”

Diagnostic Challenges in Endoscopy

“…If not managed promptly, it can be potentially life-threatening. Choi et al [2] demonstrated that although there exist a multitude of scoring systems to aid physicians in risk stratification for GI bleeding, it is important that these scoring systems are first validated in the local population. For patients presenting with overt or obscure GI bleeding, capsule endoscope is often used for investigation.…”