title: Multicentre comparison of the Glasgow Blatchford and Rockall Scores in the prediction of clinical end-points after upper gastrointestinal haemorrhage.
abstract: BACKGROUND
  The Glasgow Blatchford Score (GBS) is increasingly being used to predict intervention and outcome following upper gastrointestinal haemorrhage (UGIH).
  
  
  OBJECTIVE
  To compare the GBS with both the admission and full Rockall scores in predicting specific clinical end-points following UGIH.
  
  
  METHODS
  Data on consecutive patients presenting to four UK hospitals were collected. Admission history, clinical and laboratory data, endoscopic findings, treatment and clinical follow-up were recorded. Using ROC curves, we compared the three scores in the prediction of death, endoscopic or surgical intervention and transfusion. Results  A total of 1555 patients (mean age 56.7years) presented with UGIH during the study period. Seventy-four (4.8%) died, 223 (14.3%) had endoscopic or surgical intervention and 363 (23.3%) required transfusion. The GBS was similar at predicting death compared with both the admission Rockall (area under ROC curve 0.804 vs. 0.801) and full Rockall score (AUROC 0.741 vs. 0.790). In predicting endo-surgical intervention, the GBS was superior to the admission Rockall (AUROC 0.858 vs. 0.705; P<0.00005) and similar to the full Rockall score (AUROC 0.822 vs. 0.797). The GBS was superior to both admission Rockall (AUROC 0.944 vs. 0.756; P<0.00005) and full Rockall scores (AUROC 0.935 vs. 0.792; P<0.00005) in predicting need for transfusion.
  
  
  CONCLUSIONS
  Despite not incorporating age, the GBS is as effective as the admission and full Rockall scores in predicting death after UGIH. It is superior to both the admission and full Rockall scores in predicting need for transfusion, and superior to the admission Rockall score in predicting endoscopic or surgical intervention.
authors.affiliation: Gastrointestinal unit, Glasgow Royal Infirmary, Glasgow, UK. adrian.stanley@ggc.scot.nhs.uk
authors.forename: A J
authors.initials: AJ
authors.lastname: Stanley
authors.forename: H R
authors.initials: HR
authors.lastname: Dalton
authors.forename: O
authors.initials: O
authors.lastname: Blatchford
authors.forename: D
authors.initials: D
authors.lastname: Ashley
authors.forename: C
authors.initials: C
authors.lastname: Mowat
authors.forename: A
authors.initials: A
authors.lastname: Cahill
authors.forename: D R
authors.initials: DR
authors.lastname: Gaya
authors.forename: E
authors.initials: E
authors.lastname: Thompson
authors.forename: U
authors.initials: U
authors.lastname: Warshow
authors.forename: N
authors.initials: N
authors.lastname: Hare
authors.forename: M
authors.initials: M
authors.lastname: Groome
authors.forename: G
authors.initials: G
authors.lastname: Benson
authors.forename: W
authors.initials: W
authors.lastname: Murray
mesh_terms: D023381:Endpoint Determination; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012044:Regression Analysis; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D006113:United Kingdom; D041742:Upper Gastrointestinal Tract