Comparison of Glasgow-Blatchford score and full Rockall score systems to predict clinical outcomes in patients with upper gastrointestinal bleeding.
BACKGROUND
Various risk scoring systems have been recently developed to predict clinical outcomes in patients with upper gastrointestinal bleeding (UGIB). The two commonly used scoring systems include full Rockall score (RS) and the Glasgow-Blatchford score (GBS). Bleeding scores were assessed in terms of prediction of clinical outcomes in patients with UGIB.


METHODS
Two hundred patients (age >18 years) with obvious symptoms of UGIB in the emergency department of Rasoul Akram Hospital were enrolled. Full RS and GBS were calculated. We followed the patients for records of rebleeding and 1-month mortality. A receiver operating characteristic curve by using areas under the curve (AUCs) was used to statistically identify the best cutoff point.


RESULTS
Eighteen patients were excluded from the study due to failure to follow-up. Rebleeding and mortality rate were 9.34% (n=17) and 11.53% (n=21), respectively. Regarding 1-month mortality, full RS was better than GBS (AUC, 0.648 versus 0.582;P=0.021). GBS was more accurate in terms of detecting transfusion need (AUC, 0.757 versus 0.528;P=0.001), rebleeding rate (AUC, 0.722 versus 0.520;P=0.002), intensive care unit admission rate (AUC, 0.648 versus 0.582;P=0.021), and endoscopic intervention rate (AUC, 0.771 versus 0.650;P<0.001).


CONCLUSIONS
We found the full RS system is better for 1-month mortality prediction while GBS system is better for prediction of other outcomes.
Colorectal Research Center, Rasoul Akram Hospital, Tehran, Iran.
Marjan
M
Mokhtare
Colorectal Research Center, Rasoul Akram Hospital, Tehran, Iran.
Vida
V
Bozorgi
Colorectal Research Center, Rasoul Akram Hospital, Tehran, Iran.
Shahram
S
Agah
Colorectal Research Center, Rasoul Akram Hospital, Tehran, Iran.
Mehdi
M
Nikkhah
Colorectal Research Center, Rasoul Akram Hospital, Tehran, Iran.
Amirhossein
A
Faghihi
Colorectal Research Center, Rasoul Akram Hospital, Tehran, Iran.
Amirhossein
A
Boghratian
Colorectal Research Center, Rasoul Akram Hospital, Tehran, Iran.
Neda
N
Shalbaf
Colorectal Research Center, Rasoul Akram Hospital, Tehran, Iran.
Abbas
A
Khanlari
Colorectal Research Center, Rasoul Akram Hospital, Tehran, Iran.
Hamidreza
H
Seifmanesh
Glasgow-Blatchford score; full Rockall score; gastrointestinal bleeding; mortality; prognosis