title: Comparison of three scoring systems in predicting clinical outcomes in patients with acute upper gastrointestinal bleeding: a prospective observational study.
abstract: OBJECTIVE
  To compare the performances of the Glasgow-Blatchford score (GBS), modified GBS (mGBS) and AIMS65 in predicting clinical outcomes in patients with acute upper gastrointestinal bleeding (AUGIB).
  
  
  METHODS
  This study enrolled 320 consecutive patients with AUGIB. Patients at high and low risks of developing adverse clinical outcomes (rebleeding, the need of clinical intervention and death) were categorized according to the GBS, mGBS and AIMS65 scoring systems. The outcome of the patients were the occurrences of adverse clinical outcomes. The areas under the receiver operating characteristics curve (AUROC) of three scoring systems were compared.
  
  
  RESULTS
  Irrespective of the systems used, the high-risk groups showed higher rates of rebleeding, intervention and death compared with the low-risk groups (P < 0.05). For the prediction of rebleeding, AIMS65 (AUROC 0.735, 95% CI 0.667-0.802) performed significantly better than GBS (AUROC 0.672, 95% CI 0.597-0.747; P < 0.01) and mGBS (AUROC 0.677, 95% CI 0.602-0.753; P < 0.01). For the prediction of interventions, there was no significant difference among the three systems (GBS: AUROC 0.769, 95% CI 0.668-0.870; mGBS: AUROC 0.745, 95% CI 0.643-0.847; AIMS65: AUROC 0.746, 95% CI 0.640-0.851). For the prediction of in-hospital mortality, there was no significant difference among the three systems (GBS: AUROC 0.796, 95% CI 0.694-0.898; mGBS: AUROC 0.803, 95% CI 0.703-0.904; AIMS65: AUROC 0.786, 95% CI 0.670-0.903).
  
  
  CONCLUSIONS
  The three scoring systems are reliable and accurate in predicting the rates of rebleeding, surgery and mortality in AUGIB. However, AIMS65 outperforms GBS and mGBS in predicting rebleeding.
authors.affiliation: Department of Emergency Medicine, Renjii Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Min
authors.initials: M
authors.lastname: Zhong
authors.affiliation: Department of Emergency Medicine, Renjii Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Wan Jun
authors.initials: WJ
authors.lastname: Chen
authors.affiliation: Department of Emergency Medicine, Renjii Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Xiao Ye
authors.initials: XY
authors.lastname: Lu
authors.affiliation: Department of Emergency Medicine, Renjii Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Qian
authors.affiliation: Department of Emergency Medicine, Renjii Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Chang Qing
authors.initials: CQ
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: AIMS65; Glasgow-Blatchford score; ROC curve; gastrointestinal hemorrhage; modified Glasgow-Blatchford score