Glasgow-Blatchford versus Rockall Scoring Systems for Predicting Outcomes of Patients with Upper Gastrointestinal Bleeding

Acute upper gastrointestinal bleeding is a common emergency and potentially fatal health problem that associated with high mortality and morbidity. Gastrointestinal endoscopy can identify the cause of bleeding and remains the cornerstone of diagnosis and therapy in gastrointestinal bleeding. Aim: The aim of this study is to compare between the Glasgow-Blatchford score and Rockall score in predicting the clinical outcomes of patients with upper gastrointestinal bleeding during hospitalization. Study design: Retrospective observational cohort research design was used to conduct this study. Setting: This study was conducted in the medicine department 1 and 2 at medical hospital affiliated to Ain Shams University Hospitals, Cairo, Egypt. Subjects: Purposive sample of 95 adult patients who were admitted to the previously mentioned settings from October 2020 to March 2021 were included in the study. Data collection tools: (1) Patients' Clinical Outcomes Assessment Questionnaire, (2) The Glasgow-Blatchford Scale, (3) The pre-endoscopic Rockall Score. Results: Regarding re-bleeding prediction, (AUC for GBS= 0.573, RS 0.534). As for mortality prediction, GBS was similar to RS (AUC 0.754 and 0.744 respectively). Regarding need for blood transfusion (AUC for GBS= 0.868 and 0.691 for RS), prediction of need for endoscopic intervention revealed that GBS was superior to RS (AUC 0.785 and 0.675 respectively). In terms of length of hospital stay, GBS and RS were quietly equivalent (AUC 0.654 and 0.657 respectively). Conclusion: The study concluded that there was no statistically significant difference between the Glasgow Blatchford Score and pre-endoscopic Rockall Score in predicting accuracy of clinical outcomes for patients with upper gastrointestinal bleeding. Recommendations: It is recommended that the pre-endoscopic Glasgow Blatchford Score and Rockall Score are considered useful tools that can be safely used to predict clinical outcomes of patients with gastrointestinal

[1]  S. A. El-Aziz,et al.  RISK STRATIFICATION OF ACUTE UPPER GI BLEEDING BY ROCKALL, GLASGOW BLATCHFORD AND AIMS 65 SCORES , 2020, Al-Azhar Medical Journal.

[2]  Amritpal S. Singh,et al.  Endoscopic profile and clinical outcome of patients presenting with upper gastrointestinal bleeding , 2020 .

[3]  A. Husic-Selimovic,et al.  Comparison of Glasgow-Blatchford Score and Rockall Score in Patients with Upper Gastrointestinal Bleeding , 2020, Medical archives.

[4]  V. Prachayakul,et al.  Prospective Comparison of the AIMS65 Score, Glasgow-Blatchford Score, and Rockall Score for Predicting Clinical Outcomes in Patients with Variceal and Nonvariceal Upper Gastrointestinal Bleeding , 2020, Clinical endoscopy.

[5]  E. Weledji Acute upper gastrointestinal bleeding: A review , 2020, Surgery in Practice and Science.

[6]  Dongliang Wang,et al.  Outcomes of Upper Gastrointestinal Bleeding Based on Time to Endoscopy: A Retrospective Study , 2020, Cureus.

[7]  L. Laine,et al.  The Shock Index is not accurate at predicting outcomes in patients with upper gastrointestinal bleeding , 2019, Alimentary pharmacology & therapeutics.

[8]  A. Samadani,et al.  Comparison of three risk scores to predict outcomes in upper gastrointestinal bleeding; modifying Glasgow-Blatchford with albumin , 2019, Romanian journal of internal medicine = Revue roumaine de medecine interne.

[9]  Amal A. Jouda,et al.  Non-variceal Causes and Outcome of Acute Upper Gastro-intestinal bleeding among Cirrhotic Patients in Tropical Medicine Intensive Care Unit , 2019, Afro-Egyptian Journal of Infectious and Endemic Diseases.

[10]  Jeongmin Choi,et al.  AIMS65 scoring system is comparable to Glasgow-Blatchford score or Rockall score for prediction of clinical outcomes for non-variceal upper gastrointestinal bleeding , 2019, BMC Gastroenterology.

[11]  Yunsheng Yang,et al.  Comparison of the Glasgow-Blatchford and Rockall Scores for prediction of nonvariceal upper gastrointestinal bleeding outcomes in Chinese patients , 2019, Medicine.

[12]  I. Waked,et al.  Upper gastrointestinal bleeding in Egyptian patients with cirrhosis: Post‐therapeutic outcome and prognostic indicators , 2019, Journal of gastroenterology and hepatology.

[13]  M. Hafez,et al.  Assessment of the Causes and Outcomes of Upper Gastrointestinal Tract Bleeding Patients in Aswan University Hospital , 2019, The Egyptian Journal of Hospital Medicine.

[14]  P. Ranganathan,et al.  Study designs: Part 1 – An overview and classification , 2018, Perspectives in clinical research.

[15]  Saeed Safari,et al.  Full and Modified Glasgow-Blatchford Bleeding Score in Predicting the Outcome of Patients with Acute Upper Gastrointestinal Bleeding; a Diagnostic Accuracy Study , 2018, Emergency.

[16]  Y. Ang,et al.  Glasgow Blatchford Score and risk stratifications in acute upper gastrointestinal bleed: can we extend this to 2 for urgent outpatient management? , 2018, Clinical medicine.

[17]  E. Redondo-Cerezo,et al.  Inhospital and delayed mortality after upper gastrointestinal bleeding: an analysis of risk factors in a prospective series , 2018, Scandinavian journal of gastroenterology.

[18]  Shivan J. Mehta,et al.  Glasgow Blatchford Score of limited benefit for low-risk urban patients: a mixed methods study , 2017, Endoscopy International Open.

[19]  I. Soykan,et al.  Comparison of three scoring systems for risk stratification in elderly patients wıth acute upper gastrointestinal bleeding , 2017, Geriatrics & gerontology international.

[20]  Michael Schultz,et al.  Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study , 2017, British Medical Journal.

[21]  S. Agah,et al.  Comparison of Glasgow-Blatchford score and full Rockall score systems to predict clinical outcomes in patients with upper gastrointestinal bleeding , 2016, Clinical and experimental gastroenterology.

[22]  E. Redondo-Cerezo,et al.  Comparison of AIMS65, Glasgow–Blatchford score, and Rockall score in a European series of patients with upper gastrointestinal bleeding: performance when predicting in-hospital and delayed mortality , 2016, United European gastroenterology journal.

[23]  Ats Tsui,et al.  Validation of a Modified Glasgow-Blatchford Score for Risk Stratification of Patients with Suspected Upper Gastrointestinal Bleeding in an Accident and Emergency Department in Hong Kong , 2016 .

[24]  Xin Zhang,et al.  Patient outcomes in the field of nursing: A concept analysis , 2014 .

[25]  H B Devlin,et al.  Risk assessment after acute upper gastrointestinal haemorrhage. , 1996, Gut.

[26]  D. Oleske,et al.  Role of Epidemiology in the Biopharmaceutical Industry , 2019, Pharmacovigilance: A Practical Approach.

[27]  Jie Shen,et al.  Scoring systems used to predict mortality in patients with acute upper gastrointestinal bleeding in the ED , 2018, The American journal of emergency medicine.

[28]  D. Balaban,et al.  Predictors for in-hospital mortality and need for clinical intervention in upper GI bleeding: a 5-year observational study. , 2014, Chirurgia.