Comparison of risk scoring systems for the prediction of clinical outcomes in nonvariceal upper gastrointestinal bleeding: a prospective randomized study

Muhammed Bahaddin Durak; Batuhan Başpınar; İbrahim Ethem Güven; İlhami Yüksel

Makale detayları

Comparison of risk scoring systems for the prediction of clinical outcomes in nonvariceal upper gastrointestinal bleeding: a prospective randomized study

Yazarlar:

Muhammed Bahaddin Durak | Batuhan Başpınar | İbrahim Ethem Güven | İlhami Yüksel

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Sağlık Kurumları Yönetimi

Dergi:

Journal of Health Sciences and Medicine Vol.6 Issue 3, pp.643-649

Belge Tipi:

Makale

Yayın Tarihi:

5/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001290574

pISSN:

2636-8579

Anahtar kelimeler:

Özet:

 Aim: Non-variceal upper gastrointestinal bleeding UGIB is a typical gastrointestinal emergency. Detection of high-risk patients is crucial to organize medical care accordingly. This study aims to compare risk assessment scores for their ability to predict prognosis in nonvariceal-UGIB. Material and Method: Adult patients with nonvariceal-UGIB applied to the emergency department were recruited prospectively. Clinical and Complete Rockall score RS, Glascow-Blatchford score GBS, AIMS65, and T-Score were compared for endpoints: 1 need for endoscopic treatment, 2 hospitalization, 3 rebleeding, and 4 30-day mortality. Results: A total of 469 patients were included. While 133 28.0 patients were discharged within 24 hours, 336 72.0 were hospitalized. The median length of hospital stay was 6.6 0.0-8.0 days. Endoscopic treatment and transfusion were required in 109 23.0 and 255 54.0 patients, respectively. Rebleeding was observed in 36 8.0 patients. The 30-day mortality rate was 11.0 . Complete Rockall score was superior among all risk scores regarding the prediction of the need for endoscopic treatment AUC: 0.707, p0.001 and hospitalization AUC: 0.678, p0.001. AUC values of AIMS65, Clinical RS, Complete RS, GBS, and T-score were 0.688, 0.601, 0.634, 0.631, and 0.651, respectively p0.05. AIMS65 score AUC: 0.810, p0.05 was superior to the clinical RS and GBS at predicting 30-day mortality. However, there was no difference between the AIMS65 score and the other scores of areas under the curve p 0.05. Conclusion: Complete RS and AIMS65 scores are valuable tools to determine UGIB-related endpoints need for intervention, hospitalization, rebleeding, and mortality. Identifying high-risk patients using the risk scoring systems and performing endoscopy in this group may improve clinical outcomes, while their sensitivity is inadequate in the low-risk patients.

 Aim: Non-variceal upper gastrointestinal bleeding UGIB is a typical gastrointestinal emergency. Detection of high-risk patients is crucial to organize medical care accordingly. This study aims to compare risk assessment scores for their ability to predict prognosis in nonvariceal-UGIB. Material and Method: Adult patients with nonvariceal-UGIB applied to the emergency department were recruited prospectively. Clinical and Complete Rockall score RS, Glascow-Blatchford score GBS, AIMS65, and T-Score were compared for endpoints: 1 need for endoscopic treatment, 2 hospitalization, 3 rebleeding, and 4 30-day mortality. Results: A total of 469 patients were included. While 133 28.0 patients were discharged within 24 hours, 336 72.0 were hospitalized. The median length of hospital stay was 6.6 0.0-8.0 days. Endoscopic treatment and transfusion were required in 109 23.0 and 255 54.0 patients, respectively. Rebleeding was observed in 36 8.0 patients. The 30-day mortality rate was 11.0 . Complete Rockall score was superior among all risk scores regarding the prediction of the need for endoscopic treatment AUC: 0.707, p0.001 and hospitalization AUC: 0.678, p0.001. AUC values of AIMS65, Clinical RS, Complete RS, GBS, and T-score were 0.688, 0.601, 0.634, 0.631, and 0.651, respectively p0.05. AIMS65 score AUC: 0.810, p0.05 was superior to the clinical RS and GBS at predicting 30-day mortality. However, there was no difference between the AIMS65 score and the other scores of areas under the curve p 0.05. Conclusion: Complete RS and AIMS65 scores are valuable tools to determine UGIB-related endpoints need for intervention, hospitalization, rebleeding, and mortality. Identifying high-risk patients using the risk scoring systems and performing endoscopy in this group may improve clinical outcomes, while their sensitivity is inadequate in the low-risk patients.

 Aim: Non-variceal upper gastrointestinal bleeding UGIB is a typical gastrointestinal emergency. Detection of high-risk patients is crucial to organize medical care accordingly. This study aims to compare risk assessment scores for their ability to predict prognosis in nonvariceal-UGIB. Material and Method: Adult patients with nonvariceal-UGIB applied to the emergency department were recruited prospectively. Clinical and Complete Rockall score RS, Glascow-Blatchford score GBS, AIMS65, and T-Score were compared for endpoints: 1 need for endoscopic treatment, 2 hospitalization, 3 rebleeding, and 4 30-day mortality. Results: A total of 469 patients were included. While 133 28.0 patients were discharged within 24 hours, 336 72.0 were hospitalized. The median length of hospital stay was 6.6 0.0-8.0 days. Endoscopic treatment and transfusion were required in 109 23.0 and 255 54.0 patients, respectively. Rebleeding was observed in 36 8.0 patients. The 30-day mortality rate was 11.0 . Complete Rockall score was superior among all risk scores regarding the prediction of the need for endoscopic treatment AUC: 0.707, p0.001 and hospitalization AUC: 0.678, p0.001. AUC values of AIMS65, Clinical RS, Complete RS, GBS, and T-score were 0.688, 0.601, 0.634, 0.631, and 0.651, respectively p0.05. AIMS65 score AUC: 0.810, p0.05 was superior to the clinical RS and GBS at predicting 30-day mortality. However, there was no difference between the AIMS65 score and the other scores of areas under the curve p 0.05. Conclusion: Complete RS and AIMS65 scores are valuable tools to determine UGIB-related endpoints need for intervention, hospitalization, rebleeding, and mortality. Identifying high-risk patients using the risk scoring systems and performing endoscopy in this group may improve clinical outcomes, while their sensitivity is inadequate in the low-risk patients.

 GirişAmaç: Varis dışı üst gastrointestinal kanama UGIB tipik bir gastrointestinal acil durumdur. Yüksek riskli hastaların tespiti ve medikal yaklaşımı buna göre belirlemek çok önemlidir. Bu çalışma, varis dışı-UGIBde prognozu predikte etme açısından risk değerlendirme puanlarını karşılaştırmayı amaçlamaktadır. Gereç ve Yöntemler: Acil servise varis dışı UGIB ile başvuran erişkin hastalar prospektif olarak çalışmaya alındı. Klinik ve Full Rockall skoru RS, Glascow-Blatcford skoru GBS, AIMS65 ve T-Skoru, 1 endoskopik tedavi ihtiyacı, 2 hospitalizasyon ihtiyacı, 3 tekrar kanama ve 4 30 günlük mortalite açısından karşılaştırıldı. Bulgular: Toplam 469 hasta dahil edildi. 133 28,0 hasta 24 saat içinde taburcu edilirken, 336 72,0 hasta hastaneye yatırıldı. Hastanede kalış süresi medyan 6,6 0,0-8,0 gündü. Endoskopik tedavi ihtiyacı 109 23,0, transfüzyon ihtiyacı 255 54,0 hastada gerekti. 36 8,0 hastada tekrar kanama görüldü. 30 günlük mortalite oranı 11.0 idi. Endoskopik tedavi AUC: 0.707, p0.001 ve hastaneye yatış EAA: 0.678, p0.001 gereksinimini predikte etmede Total Rockall skoru tüm risk skorları arasında üstündü. AIMS65 skoru EAA: 0.810, p0.05, 30 günlük mortaliteyi öngörmede klinik RS ve GBSden üstündü. Sonuç: GBS ve AIMS65 skorları, UGIB ile ilişkili sonlanım noktalarını endoskopik tedavi ihtiyacı, hastaneye yatış, tekrar kanama ve mortalite belirlemek için değerli skorlama sistemleridir. Risk skorlama sistemlerini kullanarak yüksek riskli hastaların belirlenmesi ve bu grupta endoskopi yapılması klinik sonuçları iyileştirebilirken, düşük riskli hastalarda duyarlılıkları yetersizdir.

Makale detayları

Comparison of risk scoring systems for the prediction of clinical outcomes in nonvariceal upper gastrointestinal bleeding: a prospective randomized study

Yazarlar:

Muhammed Bahaddin Durak | Batuhan Başpınar | İbrahim Ethem Güven | İlhami Yüksel

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Sağlık Kurumları Yönetimi

Dergi:

Journal of Health Sciences and Medicine Vol.6 Issue 3, pp.643-649

Belge Tipi:

Makale

Yayın Tarihi:

5/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001290574

pISSN:

2636-8579

Gastrointestinal hemorrhage

endoscopy

risk assessment

prognosisGastrointestinal hemoraji

Endoskopi

Risk değerlendirmesi

Prognoz

Sayı

Makale detayları

Yazarlar: Muhammed Bahaddin Durak | Batuhan Başpınar | İbrahim Ethem Güven | İlhami Yüksel

Yayıncı: MediHealth Academy Yayıncılık

Ana Başlıklar: Sağlık Kurumları Yönetimi

Dergi: Journal of Health Sciences and Medicine Vol.6 Issue 3, pp.643-649

Belge Tipi: Makale

Yayın Tarihi: 5/2023

Belge Dili: İngilizce

Document ID (Org No.): 2001290574

pISSN: 2636-8579

Sayı

Yazarlar:

Muhammed Bahaddin Durak | Batuhan Başpınar | İbrahim Ethem Güven | İlhami Yüksel

Yayıncı:

MediHealth Academy Yayıncılık

Ana Başlıklar:

Sağlık Kurumları Yönetimi

Dergi:

Journal of Health Sciences and Medicine Vol.6 Issue 3, pp.643-649

Belge Tipi:

Makale

Yayın Tarihi:

5/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001290574

pISSN:

2636-8579