Can Glasgow-Blatchford Score and Pre-endoscopic Rockall Score Predict the Occurrence of Hypotension in Initially Normotensive Patients with Non-variceal Upper Gastrointestinal Bleeding?.
- Author:
June Sung KIM
1
;
Byuk Sung KO
;
Chang Hwan SON
;
Shin AHN
;
Dong Woo SEO
;
Yoon Seon LEE
;
Jae Ho LEE
;
Bum Jin OH
;
Kyoung Soo LIM
;
Won Young KIM
Author Information
- Publication Type:Original Article
- Keywords: Gastrointestinal bleeding; Emergency department; Score; Hypotension
- MeSH: Adult; Aged; Area Under Curve; Demography; Emergency Service, Hospital; Female; Gastrointestinal Hemorrhage/complications/*diagnosis/pathology; Humans; Hypotension/epidemiology/*etiology; Male; Middle Aged; Predictive Value of Tests; ROC Curve; Retrospective Studies; Severity of Illness Index; Upper Gastrointestinal Tract
- From:The Korean Journal of Gastroenterology 2016;67(1):16-21
- CountryRepublic of Korea
- Language:Korean
- Abstract: BACKGROUND/AIMS: The aim of this study was to identify the ability of Glasgow-Blatchford score (GBS) and pre-endoscopic Rockall score (pre-E RS) to predict the occurrence of hypotension in patients with non-variceal upper gastrointestinal bleeding who are initially normotensive at emergency department. METHODS: Retrospective observational study was conducted at Asan Medical Center emergency department (ED) in patients who presented with non-variceal upper gastrointestinal bleeding from January 1, 2011 to December 31, 2013. Study population was divided according to the development of hypotension, and demographics, comorbidities, and laboratory findings were compared. GBS and pre-E RS were estimated to predict the occurrence of hypotension. RESULTS: A total of 747 patients with non-variceal upper gastrointestinal bleeding were included during the study period, and 120 (16.1%) patients developed hypotesion within 24 hours after ED admission. The median values GBS and pre-E RS were statistically different according to the occurrence of hypotension (8.0 vs. 10.0, 2.0 vs. 3.0, respectively; p<0.001). In the receiver operating characteristic curve analysis of hypotension development, the area under the curve of GBS and pre-E RS were 66% and 64%, respectively. The sensitivity and the specificity of GBS using optimal cut-off value were 81% and 46%, respectively, while those based on the pre-E RS were 74% and 46%, respectively. CONCLUSIONS: GBS and pre-E RS were both not sufficient for predicting the occurrence of hypotension in non-variceal upper gastrointestinal bleeding. Development of other scoring systems are needed.
