title: Prospective comparison of three risk scoring systems in non-variceal and variceal upper gastrointestinal bleeding.
abstract: OBJECTIVE
  Data regarding the efficacy of the Glasgow Blatchford score (GBS), full Rockall score (FRS) and pre-endoscopic Rockall scores (PRS) in comparing non-variceal and variceal upper gastrointestinal bleeding (UGIB) are limited. Our aim was to determine the performance of these three risk scores in predicting the need for treatment, mortality, and re-bleeding among patients with non-variceal and variceal UGIB.
  
  
  METHODS
  During January, 2010 and September, 2011, patients with UGIB from 11 hospitals were prospectively enrolled. The GBS, FRS, and PRS were calculated. Discriminative ability for each score was assessed using the receiver operated characteristics curve (ROC) analysis.
  
  
  RESULTS
  A total of 981 patients presented with acute UGIB, 225 patients (22.9%) had variceal UGIB. The areas under the ROC (AUC) of the GBS, FRS, and PRS for predicting the need for treatment were 0.77, 0.69, and 0.61 in non-variceal versus 0.66, 0.66, and 0.59 in variceal UGIB. The AUC for predicting mortality and re-bleeding during admission were 0.66, 0.80, and 0.76 in non-variceal versus 0.63, 0.57, and 0.63 in variceal UGIB. AUC score was not statistically significant for predicting need for therapy and clinical outcome in variceal UGIB. The GBS ≤ 2 and FRS ≤ 1 identified low-risk non-variceal UGIB patients for death and re-bleeding during hospitalization.
  
  
  CONCLUSIONS
  In contrast to non-variceal UGIB, the GBS, FRS, and PRS were not precise scores for assessing the need for therapy, mortality, and re-bleeding during admission in variceal UGIB.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
authors.forename: Kessarin
authors.initials: K
authors.lastname: Thanapirom
authors.affiliation: Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
authors.forename: Wiriyaporn
authors.initials: W
authors.lastname: Ridtitid
authors.affiliation: Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
authors.forename: Rungsun
authors.initials: R
authors.lastname: Rerknimitr
authors.affiliation: Division of Gastroenterology, Sawanpracharak Hospital, Nakhon Sawan, Thailand.
authors.forename: Rattikorn
authors.initials: R
authors.lastname: Thungsuk
authors.affiliation: Division of Gastroenterology, Surin Hospital, Surin, Thailand.
authors.forename: Phadet
authors.initials: P
authors.lastname: Noophun
authors.affiliation: Division of Gastroenterology, HRH Princess Maha Chakri Sirindhorn Medical Center-MSMC Hospital, Bangkok, Thailand.
authors.forename: Chatchawan
authors.initials: C
authors.lastname: Wongjitrat
authors.affiliation: Division of Gastroenterology, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand.
authors.forename: Somchai
authors.initials: S
authors.lastname: Luangjaru
authors.affiliation: Division of Gastroenterology, Maharaj Nakhon Si Thammarat Hospital, Nakhon Si Thammarat, Thailand.
authors.forename: Padet
authors.initials: P
authors.lastname: Vedkijkul
authors.affiliation: Division of Gastroenterology, Chonburi Hospital, Chonburi, Thailand.
authors.forename: Comson
authors.initials: C
authors.lastname: Lertkupinit
authors.affiliation: Division of Gastroenterology, Bangkok Hospital, Bangkok, Thailand.
authors.forename: Swangphong
authors.initials: S
authors.lastname: Poonsab
authors.affiliation: Department of Surgery, Rajavithi Hospital, Bangkok, Thailand.
authors.forename: Thawee
authors.initials: T
authors.lastname: Ratanachu-ek
authors.affiliation: Division of Gastroenterology, Rajavithi Hospital, Bangkok, Thailand.
authors.forename: Piyathida
authors.initials: P
authors.lastname: Hansomburana
authors.affiliation: Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Thammasat University Hospital, Pathum Thani, Thailand.
authors.forename: Bubpha
authors.initials: B
authors.lastname: Pornthisarn
authors.affiliation: Division of Gastroenterology, Bangkok Metropolitan Administration General Hospital, Bangkok, Thailand.
authors.forename: Thirada
authors.initials: T
authors.lastname: Thongbai
authors.affiliation: Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
authors.forename: Varocha
authors.initials: V
authors.lastname: Mahachai
authors.affiliation: Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
authors.forename: Sombat
authors.initials: S
authors.lastname: Treeprasertsuk
mesh_terms: D000368:Aged; D005260:Female; D005544:Forecasting; D006471:Gastrointestinal Hemorrhage / Q000401:mortality / Q000628:therapy; D041981:Gastrointestinal Tract / Q000098:blood supply*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D018570:Risk Assessment / Q000379:methods*; D016896:Treatment Outcome; D014648:Varicose Veins / Q000401:mortality / Q000628:therapy
keywords: Glasgow-Blatchford bleeding score; Rockall score; accuracy; risk stratification; upper gastrointestinal bleeding