Predictive Value of the CRUSADE Score for Rebleeding and Mortality in Upper Gastrointestinal Bleeding

Abstract

Objective: Upper gastrointestinal (GI) bleeding is associated with significant morbidity and mortality. This study aimed to compare the performance of the Rockall, Glasgow-Blatchford, and CRUSADE scoring systems in predicting mortality and rebleeding in patients with upper GI bleeding. Materials and Methods: In this retrospective study, 194 patients diagnosed with upper GI bleeding between January 1, 2019, and December 31, 2021 were included. Demographic, clinical, and laboratory data were analyzed. Rockall, Glasgow-Blatchford, and CRUSADE scores were calculated. The predictive performance of the scores for mortality and rebleeding was evaluated using ROC analysis. Results: The mean age was 66.3±17.15 years, and 67.5% of the patients were male. Rebleeding occurred in 30.9% of patients, in-hospital mortality was 8.8%, and 1-year mortality was 23.1%. ROC analysis showed that the Rockall score had the highest AUC for predicting mortality (0.81). The Glasgow-Blatchford score was associated with mortality timing, whereas the CRUSADE score showed a significant association with rebleeding. Conclusion: Rockall, Glasgow-Blatchford, and CRUSADE scores provide valuable prognostic information for different clinical outcomes in patients with upper GI bleeding. The Rockall score was most effective for predicting early mortality, the Glasgow-Blatchford score for mid- and long-term mortality, and the CRUSADE score for rebleeding risk.

Keywords

• Upper gastrointestinal bleeding
• CRUSADE score
• Rockall score
• Glasgow-Blatchford score
• mortality
• rebleeding

Supporting Institution

Tokat Gaziosmanpaşa University

Project Number

1

Ethical Statement

Ethical approval for this study was obtained from the Tokat Gaziosmanpaşa University Ethics Committee (Approval No: 22-KAEK-27, decision date: September 22, 2022). The study was conducted in accordance with the principles of the Declaration of Helsinki. Due to the retrospective design of the study, informed consent was waived.

Üst Gastrointestinal Kanamalarda Yeniden Kanama ve Mortaliteyi Öngörmede CRUSADE Skorunun Değeri

Abstract

ÖZ Amaç: Üst gastrointestinal sistem (GİS) kanamaları, yüksek morbidite ve mortalite ile ilişkili önemli klinik durumlardır. Bu çalışmada Rockall, Glasgow-Blatchford ve CRUSADE skorlama sistemlerinin, üst GİS kanamalı hastalarda mortalite ve yeniden kanama riskini öngörmedeki performanslarının karşılaştırılması amaçlandı. Gereç ve Yöntem: Bu retrospektif çalışmaya, 01 Ocak 2019–31 Aralık 2021 tarihleri arasında üst GİS kanaması tanısı alan 194 hasta dahil edildi. Hastaların demografik, klinik ve laboratuvar verileri incelendi. Rockall, Glasgow-Blatchford ve CRUSADE skorları hesaplandı. Skorların mortalite ve yeniden kanamayı öngörme performansı ROC analizi ile değerlendirildi. Bulgular: Ortalama yaş 66,3±17,15 yıl olup hastaların %67,5’i erkekti. Yeniden kanama oranı %30,9, hastane içi mortalite %8,8 ve 1 yıllık mortalite %23,1 olarak bulundu. ROC analizinde Rockall skorunun mortaliteyi öngörmede en yüksek AUC değerine sahip olduğu (0,81) görüldü. Glasgow-Blatchford skoru mortalite zamanlaması ile ilişkili bulunurken, CRUSADE skorunun yeniden kanama ile anlamlı ilişkisi saptandı. Sonuç: Rockall, Glasgow-Blatchford ve CRUSADE skorları üst GİS kanamalı hastalarda farklı prognostik sonlanımlar açısından değerli bilgiler sağlamaktadır. Rockall skoru erken mortaliteyi, Glasgow-Blatchford skoru orta ve uzun dönem mortaliteyi, CRUSADE skoru ise yeniden kanama riskini öngörmede klinik olarak anlamlı bulunmuştur.

Keywords

• Üst gastrointestinal kanama
• CRUSADE skoru
• Rockall skoru
• Glasgow-Blatchford skoru
• mortalite
• yeniden kanama

Supporting Institution

Tokat Gaziosmanpaşa Üniversitesi

Project Number

1

Ethical Statement

Bu çalışma, Tokat Gaziosmanpaşa Üniversitesi İç Hastalıkları Anabilim Dalı’nda Araştırma Görevlisi Dr. Melih Çalışkan’ın “Gastrointestinal sistem kanaması olan hastaların kanama tekrarı ve mortalite riskinin Crusade skoru ile değerlendirilmesi” başlıklı uzmanlık tezinden türetilmiştir. Çalışma için Tokat Gaziosmanpaşa Üniversitesi Etik Kurulu’ndan onay alınmıştır (Karar No: 22-KAEK-27, Tarih: 22.09.2022).

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