Rockall risk score in predicting 30 days non-variceal upper gastrointestinal rebleeding in a Malaysian population
- Author:
Henry Tan Chor Lip
;
Heah Hsin Tak
;
Tan Jih Huei
;
Premaa Supramaniam
;
Sarojah A/P Arulanantham
- Publication Type:Journal Article
- Keywords:
Rockall score;
non-variceal gastrointestinal bleeding;
rebleeding;
mortality;
surgery
- From:
The Medical Journal of Malaysia
2016;71(5):225-230
- CountryMalaysia
- Language:English
-
Abstract:
Objective: the aim of this study was to determine the
usefulness of Rockall score in predicting outcomes of 30
days rebleeding, mortality and need for surgical intervention
of bleeding gastric and duodenal ulcers.
Methods: this is a retrospective cohort study of all the
emergency endoscopies performed in Hospital sultan Ismail
from January 2009 to October 2014 for indications of upper
gastrointestinal bleeding (UGIb). Data was extracted from
hospital's electronic database and only non-variceal bleeds
were included. Rockall score was calculated and outcomes
of 30 days rebleeding, mortality and need for surgery was
recorded. For each outcome, calibration was done using the
Goodness-of-fit tests and discriminative ability was
reflected by area under the receiver operating characteristic
curve (AUROc).
Results: A total of 1323 patients were included with a male
preponderance of 64%. the overall rates of rebleeding were
11.2%, mortality rate of 8.7% and need for surgery was 2%.
Low AUROc values for rebleeding (0.63), mortality (0.58) and
surgery (0.67) showed poor discriminative ability of Rockall
score. the Goodness-of-fit test also revealed that the
scoring system was poorly calibrated in outcomes of
rebleeding (p <0.001), mortality (p = 0.001) and surgery (p =
0.038) with p-value <0.05. Patients with high risk (scores ≥8)
displayed highest rebleeding and mortality rates of 20%
respectively in comparison to the moderate (score 3-7) and
low (score ≤2) risk groups.
conclusion: Rockall score has a poor discriminative ability
and is poorly calibrated for rebleeding, mortality and need
for surgery in upper gastrointestinal bleeding. However, it is
the best tool we have now to stratify patients into risk
groups.
- Full text:P020170208330627738863.pdf
