Comparison of three pre-endoscopic scoring systems for prognosis evaluation of high risk acute upper gastrointestinal bleeding

ObjectiveTo explore the prognostic value of three pre-endoscopic scoring systems AIMS65, Glasgow-Blachford(GBS) and Pre-Rockall in patients with high risk acute upper gastrointestinal bleeding(AUGIB).

MethodsClinical data of 299 patients with high risk AUGIB were retrospectively analyzed, and the diagnosis and treatment outcome were reviewed.The death in hospital or death and rebleeding within 30 days were taken as the study endpoints.The ROC curve was draw, and area under the curve(AUC) was compared.Clinical values among the three scores were evaluated by ROC and AUC.

ResultsThe mortality of patients undergoing emergency gastroscopy in 0-12 h was higher than patients undergoing emergency gastroscopy in 13-24 h and >24 h(P < 0.05).In predicting in-hospital death or 30-day mortality, the AUC of AMIS65, Pre-Rocall and GBS were 0.820, 0.812 and 0.516, respectively, the AMIS65 was best, followed by Pre-Rocall, there were no significant differences between the two scored(P>0.05).In predicting in-hospital or 30-day rebleeding, the AUC of AMIS65, Pre-Rocall and GBS were 0.729, 0.676 and 0.511, respectively, the AMIS65 was best, followed by Pre-Rocall, there were no significant differences between the two scored(P>0.05).In predicting blood transfusion, the AUC of AMIS65, Pre-Rocall and GBS were 0.709, 0.591 and 0.646, respectively, the AMIS65 was best, followed by GBS, there were no significant differences between the two scored(P>0.05).

ConclusionsAIMS65 and Pre-Rockall can accurately predict the mortality rate and rebleeding rate of patients, which are suitable for pre-endoscopic assessment of high risk AUGIB.