title: Comparison of scoring systems for nonvariceal upper gastrointestinal bleeding: a multicenter prospective cohort study.
abstract: OBJECTIVE
  The Glasgow-Blatchford score (GBS) and Rockall score (RS) are widely used to assess risk in patients with upper gastrointestinal bleeding (UGIB). We compared both scoring systems and evaluated their clinical usefulness.
  
  
  METHODS
  Between February 2011 and December 2013, 1584 patients with nonvariceal UGIB were included in the study. A prospective study was conducted to compare the performance of the GBS, pre-RS, and full RS. We compared the performance of these scores using receiver operating characteristic curves.
  
  
  RESULTS
  For prediction of the need for hospital-based intervention, the GBS was similar to the full RS (area under the receiver operating characteristic curves [AUROC] 0.705 vs 0.727; P = 0.282) and superior to the pre-RS (AUROC 0.705 vs 0.601; P < 0.0001). In predicting death, the full RS was superior to the GBS (AUROC 0.758 vs 0.644; P = 0.0006) and similar to the pre-RS (AUROC 0.758 vs 0.754; P = 0.869). In predicting rebleeding, the full RS was superior to both GBS (AUROC 0.642 vs 0.585; P = 0.031) and pre-RS (AUROC 0.642 vs 0.593; P = 0.0003). Of 1584 patients, 13 (0.8%) scored 0 on the GBS. Therapeutic intervention was not performed in any of these patients.
  
  
  CONCLUSIONS
  The GBS is more useful than the pre-RS for predicting the need for hospital-based intervention. A cutoff value of 0 for low-risk patients who might be suitable for outpatient management is useful. The full RS is helpful in predicting death. None of the systems accurately predict rebleeding with a low AUROC. (
  
  
  BACKGROUND
  cris.nih.go.kr/KCT0000514).
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital/ School of Medicine.
authors.forename: Hae Min
authors.initials: HM
authors.lastname: Yang
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital/ School of Medicine.
authors.forename: Seong Woo
authors.initials: SW
authors.lastname: Jeon
authors.affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine.
authors.forename: Jin Tae
authors.initials: JT
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Catholic University of Daegu School of Medicine.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Gyeongsang National University Hospital, Jinju.
authors.forename: Chang Yoon
authors.initials: CY
authors.lastname: Ha
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine.
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Yeungnam University College of Medicine, Daegu.
authors.forename: Si Hyung
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Dongguk University School of Medicine, Gyeongju.
authors.forename: Chang Heon
authors.initials: CH
authors.lastname: Yang
authors.affiliation: Department of Internal Medicine, Dongguk University School of Medicine, Gyeongju.
authors.forename: Jun Hyung
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Soonchunhyang University Hospital, Gumi, South Korea.
authors.forename: Youn Sun
authors.initials: YS
authors.lastname: Park
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D019540:Area Under Curve; D015331:Cohort Studies; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000401:mortality / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D012306:Risk; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
keywords: intervention; mortality; upper gastrointestinal bleeding