title: A prospective comparison of 3 scoring systems in upper gastrointestinal bleeding.
abstract: BACKGROUND
  The clinical severities of upper gastrointestinal bleeding (UGIB) are of a wide variety, ranging from insignificant bleeds to fatal outcomes. Several scoring systems have been designed to identify UGIB high- and low-risk patients. The aim of our study was to compare the Glasgow-Blatchford score (GBS) with the preendoscopic Rockall score (PRS) and the complete Rockall score (CRS) in their utilities in predicting clinical outcomes in patients with UGIB.
  
  
  METHODS
  We designed a prospective study to compare the performance of the GBS, PRS, and CRS in predicting primary and secondary outcomes in UGIB patients. The primary outcome included the need for blood transfusion, endoscopic therapy, or surgical intervention and was labeled as high risk. The secondary outcomes included rebleeding and 30-day mortality. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and positive and negative predictive values for each system were analyzed. A total of 303 consecutive patients admitted with UGIB during a 1-year period were enrolled.
  
  
  RESULTS
  For prediction of high-risk group, AUC was obtained for GBS (0.808), PRS (0.604), and CRS (0.767). For prediction of rebleeding, AUC was obtained for GBS (0.674), PRS (0.602), and CRS (0.621). For prediction of mortality, AUC was obtained for GBS (0.513), PRS (0.703), and CRS (0.620).
  
  
  CONCLUSIONS
  In detecting high-risk patients with acute UGIB, GBS may be a useful risk stratification tool. However, none of the 3 score systems has good performance in predicting rebleeding and 30-day mortality because of low AUCs.
authors: Department of Emergency Medicine, Chang Gung Memorial Hospital, Puzih City, Chiayi County 613, Taiwan.
authors: Cheng-Hsien
authors: CH
authors: Wang
authors: Yu-Wei
authors: YW
authors: Chen
authors: Yui-Rwei
authors: YR
authors: Young
authors: Chia-Jung
authors: CJ
authors: Yang
authors: I-Chuan
authors: IC
authors: Chen
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D003131:Combined Modality Therapy; D004935:Esophageal Diseases / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013272:Stomach Diseases / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy