title: Performance of the Rockall scoring system in predicting the need for intervention and outcomes in patients with nonvariceal upper gastrointestinal bleeding in a Brazilian setting: a prospective study.
abstract: OBJECTIVE
  This prospective study investigated the performance of pre-endoscopy and the complete Rockall scores in predicting the occurrence of adverse outcomes and the need for endoscopic or surgical intervention in patients with nonvariceal upper gastrointestinal bleeding.
  
  
  METHODS
  All 656 consecutive patients who underwent endoscopy due to nonvariceal upper gastrointestinal bleeding between 2007 and 2011 were included. Receiver operating characteristic (ROC) curves were plotted for the outcomes of therapeutic intervention, rebleeding and death. The discriminative accuracy of the risk scores was assessed by the area under the ROC curve.
  
  
  RESULTS
  Endoscopic treatment was performed in 55.2% of the patients. Rebleeding and mortality rates were 7.6 and 3.8%, respectively. The pre-endoscopy Rockall scores showed unsatisfactory accuracy in predicting the need for intervention, rebleeding or death, as shown by the respective area under the ROC curve values of 0.52, 0.52 and 0.65. The accuracy of the complete Rockall score in predicting rebleeding was poor (area under ROC: 0.52), but it was higher for mortality (area under ROC: 0.69).
  
  
  CONCLUSIONS
  The pre-endoscopy Rockall score was not useful for predicting the need for therapeutic intervention or adverse outcomes. The complete Rockall score showed an acceptable performance in predicting mortality, but was unable to predict rebleeding.
authors: Gastrocenter and Gastroenterology Unit, Faculty of Medical Sciences, State University of Campinas - Unicamp, Campinas, Brazil.
authors: Juliana
authors: J
authors: Custódio Lima
authors: Ciro
authors: C
authors: Garcia Montes
authors: Cristiane
authors: C
authors: Kibune Nagasako
authors: Glaucia Fernanda
authors: GF
authors: Soares Ruppert Reis
authors: José Olympio
authors: JO
authors: Meirelles Dos Santos
authors: Fabio
authors: F
authors: Guerrazzi
authors: Maria Aparecida
authors: MA
authors: Mesquita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001938:Brazil; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D005770:Gastrointestinal Neoplasms / Q000150:complications*; D016558:Hemostasis, Endoscopic; D006801:Humans; D008297:Male; D008309:Mallory-Weiss Syndrome / Q000150:complications; D008875:Middle Aged; D020380:Needs Assessment; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality / Q000628:therapy; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D013997:Time Factors