title: Glasgow Blatchford, pre-endoscopic Rockall and AIMS65 scores show no difference in predicting rebleeding rate and mortality in variceal bleeding.
abstract: OBJECTIVE
  To compare the performance of the Glasgow Blatchford score (GBS), pre-endoscopic Rockall score (PRS) and AIMS65 score in predicting specific clinical endpoints following variceal upper gastrointestinal hemorrhage (UGIH).
  
  
  METHODS
  Between January 2008 and December 2013, we retrospectively analyzed 225 consecutive hospitalized patients managed for endoscopically confirmed UGIH.
  
  
  RESULTS
  A total of 225 patients (mean age 61.3 years), mostly diagnosed with alcoholic cirrhosis (195/86.7%), presented with variceal UGIH during the study period. Rebleeding occurred in 22 (9.8%) patients and 30-day mortality was 39 (17.3%). Initial hemostasis was achieved with N-butyl cyanoacrylate (151/79.1%) and endoscopic variceal ligation (40/20.9%), while secondary rebleeding prophylaxis in 110 (48.9%) patients was accomplished using endoscopic variceal ligation (92%). The majority of patients died from the underlying disease, while 12 (30.8%) died from bleeding. Median hospital stay was 6 (1-35) days. There was no statistically significant difference among AIMS65, GBS and PRS in predicting mortality (AUROC 0.70 vs. 0.64 vs. 0.66) or rebleeding rates (AUROC 0.74 vs. 0.60 vs. 0.67). The GBS was superior in predicting the need for blood transfusion compared to AIMS65 score (AUROC 0.75 vs. 0.61, p = 0.01) and PRS (AUROC 0.75 vs. 0.58, p = 0.009).
  
  
  CONCLUSIONS
  The AIMS65, GBS and PRS scores are comparable but not useful for predicting outcome in patients with variceal UGIH because of poor discriminative ability. The GBS is superior in predicting the need for transfusion compared to AIMS65 score and PRS.
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine , "Sestre Milosrdnice" University Hospital Centre, School of Medicine and Dental Medicine, University of Zagreb , Zagreb , Croatia ;
authors.forename: Ivan
authors.initials: I
authors.lastname: Budimir
authors.affiliation: b Department of Internal Medicine , County Hospital Čakovec , Čakovec , Croatia ;
authors.forename: Marina
authors.initials: M
authors.lastname: Gradišer
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine , "Sestre Milosrdnice" University Hospital Centre, School of Medicine and Dental Medicine, University of Zagreb , Zagreb , Croatia ;
authors.forename: Marko
authors.initials: M
authors.lastname: Nikolić
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine , "Sestre Milosrdnice" University Hospital Centre, School of Medicine and Dental Medicine, University of Zagreb , Zagreb , Croatia ;
authors.forename: Neven
authors.initials: N
authors.lastname: Baršić
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine , "Sestre Milosrdnice" University Hospital Centre, School of Medicine and Dental Medicine, University of Zagreb , Zagreb , Croatia ;
authors.forename: Neven
authors.initials: N
authors.lastname: Ljubičić
authors.affiliation: a Division of Gastroenterology, Department of Internal Medicine , "Sestre Milosrdnice" University Hospital Centre, School of Medicine and Dental Medicine, University of Zagreb , Zagreb , Croatia ;
authors.forename: Dominik
authors.initials: D
authors.lastname: Kralj
authors.affiliation: c Magdalena - Clinic for Cardiovascular Diseases of the Faculty of Osijek , Krapinske Toplice , Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Budimir
mesh_terms: D000368:Aged; D001803:Blood Transfusion; D017523:Croatia; D004724:Endoscopy; D004932:Esophageal and Gastric Varices / Q000150:complications*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index
keywords: Blood transfusion; esophageal and gastric varices; gastrointestinal endoscopy; gastrointestinal hemorrhage; liver cirrhosis; mortality