Age,blood tests and comorbidities and AIMS65 risk scores outperform Glasgow-Blatchford and pre-endoscopic Rockall score in patients with upper gastrointestinal bleeding

作     者：Bianca Codrina Morarasu Victorita Sorodoc Anca Haisan Stefan Morarasu Cristina Bologa Raluca Ecaterina Haliga Catalina Lionte Emilia Adriana Marciuc Mohammed Elsiddig Diana Cimpoesu Gabriel Mihail Dimofte Laurentiu Sorodoc 

作者机构：Department of Internal Medicine and ToxicologySaint Spiridon University Regional Emergency HospitalFaculty of Medicine“Grigore T.Popa”University of Medicine and PharmacyIasi 700111Romania Department of Emergency MedicineSaint Spiridon University Regional Emergency HospitalFaculty of Medicine“Grigore T.Popa”University of Medicine and PharmacyIasi 700111Romania Second Department of Surgical OncologyRegional Institute of OncologyFaculty of Medicine“Grigore T.Popa”University of Medicine and PharmacyIasi 700111Romania Department of RadiologyEmergency Hospital“Prof.Dr.N.Oblu”Faculty of Medicine“Grigore T.Popa”University of Medicine and PharmacyIasi 700309Romania Department of GatroenterologyBeaumont HospitalDublin D09V2N0Ireland 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2023年第11卷第19期

页      面：4513-4530页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Glasgow-Blatchford Pre-endoscopic Rockall Age older than 65 Age,blood tests and comorbidities Risk score Gastrointestinal bleeding 

摘      要：BACKGROUND Upper gastrointestinal(GI)bleeding is a life-threatening condition with high mortality *** To compare the performance of pre-endoscopic risk scores in predicting the following primary outcomes:In-hospital mortality,intervention(endoscopic or surgical)and length of admission(≥7 d).METHODS We performed a retrospective analysis of 363 patients presenting with upper GI bleeding from December 2020 to January *** calculated and compared the area under the receiver operating characteristics curves(AUROCs)of Glasgow-Blatchford score(GBS),pre-endoscopic Rockall score(PERS),albumin,international normalized ratio,altered mental status,systolic blood pressure,age older than 65(AIMS65)and age,blood tests and comorbidities(ABC),including their optimal cut-off in variceal and non-variceal upper GI bleeding *** subsequently analyzed through a logistic binary regression model,if addition of lactate increased the score *** All scores had discriminative ability in predicting in-hospital mortality irrespective of study ***65 score had the best performance in the variceal bleeding group(AUROC=0.772;P0.001),and ABC score(AUROC=0.775;P0.001)in the non-variceal bleeding ***,ABC score,at a cut-off value of 5.5,was the best predictor(AUROC=0.770,P=0.001)of inhospital mortality in both *** score was a good predictor for endoscopic treatment(AUC=0.604;P=0.046)in the variceal population,while GBS score,(AUROC=0.722;P=0.024),outperformed the other scores in predicting surgical *** of lactate to AIMS65 score,increases by 5-fold the probability of in-hospital mortality(P0.05)and by 12-fold if added to GBS score(P0.003).No score proved to be a good predictor for length of *** ABC score is the most accurate in predicting in-hospital mortality in both mixed and non-variceal bleeding *** and GBS should be used to determine need for endoscopic and surgical intervention,respective