Prospective Comparison of the 3 Most Commonly Used Scoring Systems in Patients with GI Bleeding

Yıl 2022, Cilt: 11 Sayı: 3, 426 - 433, 04.10.2022

Tufan Alatlı Salih Kocaoğlu

https://doi.org/10.53424/balikesirsbd.1105016

Öz

Aim: This study aimed to determine the most appropriate scoring system for the emergency department to facilitate the management of patients with gastrointestinal bleeding. Materials and Methods: Data were collected prospectively September’21-March’22 period in the emergency department. A total of 117 adult patients with GI bleeding were included. Composite clinical outcomes consisted of a need for surgical or endoscopic intervention, rebleeding, intensive care unit admission, or in-hospital mortality. Results: The median age of patients was 75 years and 58.1% (n=68) of them were male. Of the patients, 21 were hospitalized in the intensive care unit and 85 in the ward (17.94-72.64%). All three scoring systems can determine the hospitalization place or discharge of patients with GI bleeding. A positive and significant correlation was found between Glasgow-Blatchford and AIMS-65 and length of hospitalization (p<0.05). In-hospital mortality developed in 15 (12.82%) of the patients. Rockall, Glasgow-Blatchford, and AIMS-65 scoring systems were found to be significant for mortality prediction (AUC= 0.745 - 0.777 - 0.851). Seventy-one (60.68%) of patients received ES transfusion, and the Rockall, Glasgow-Blatchford, and AIMS-65 scoring systems were found to be significant for the prediction of ES transfusion (AUC= 0.624 - 0.826 - 0.653). Rebleeding developed in 16 (13.67%) patients. Glasgow-Blatchford and AIMS-65 scoring systems were found to be significant for rebleeding (p= 0.03-0.04). The Rockall classification was found to be insignificant (p=0.57). Conclusion: All scoring systems were successful in terms of management of patients with GI bleeding and survey estimation. The AIMS-65 scoring system stands out only in terms of rebleeding prediction. For this reason and it is more practical, we recommend the AIMS-65 scoring system for the emergency department.

Anahtar Kelimeler

Gastrointestinal bleeding, scoring systems, emergency department, complications

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

The authors would like to thank colleagues in the department of emergency department.

GIS Kanamalı Hastalarda En Sık Kullanılan 3 Skorlama Sisteminin Prospektif Karşilaştırılmasi

Öz

Amaç: Bu çalışmanın amacı Gastrointestinal kanamalı hasta yönetimini kolaylaştırmak için acil servise en uygun skorlama sistemini saptamaktır. Gereç ve Yöntem: Veriler, acil serviste 6 aylık (22.09.2021-31.03.2022) bir süre boyunca ileriye dönük olarak toplandı. GI kanaması olan yetişkin 117 hasta dahil edildi. Bileşik klinik sonuçlar, cerrahi veya endoskopik müdahale ihtiyacı, tekrar kanama, yoğun bakım ünitesine yatış veya hastane içi ölümden oluşuyordu. Bulgular: Hastaların ortanca yaşı 75 olup, %58,1'i (n=68) erkekti. Hastaların 21’i yoğun bakım, 85’i servise yatırıldı (% 17,94-72,64). Her üç skorlama sistemide hastalarının yatış yeri veya taburculuğunu belirleyebilmektedir. Glasgow-Blatchford ve AIMS-65 ile yatış süresi arasında pozitif anlamlı bir ilişki bulunmuştur (p<0,05). Hastaların 15’inde (%12,82) hastane içi mortalite gelişmiştir, Rockall, Glasgow-Blatchford, AIMS-65 skorlama sistemleri mortalite tahmini yönünden anlamlı bulunmuştur (AUC= 0.745 – 0.777 – 0,851 ). Hastaların 71’ine (%60,68) ES transfüzyonu yapılmıştır ve Rockall, Glasgow-Blatchford, AIMS-65 skorlama sistemleri ES transfüzyonu tahmini açısından anlamlı saptanmıştır (AUC= 0.624 – 0.826 – 0,653). Hastalardan 16’sında (%13,67) rebleeding gelişmiştir. Glasgow-Blatchford ve AIMS-65 skorlamaları rebleeding için anlamlı (p= 0,03-0,04), Rockall sınıflaması ise anlamsız saptanmıştır (p=0,57). Sonuç: Tüm skorlama sistemleri GIS kanama hastalarının yönetimi ve survey tahmini açısından başarılıdır. Sadece rebleeding tahmini açısından AIMS-65 ön plana çıkmaktadır. Bu sebepten ve daha pratik olduğundan AS için biz AIMS-65 skorlama sistemini önermekteyiz.

Anahtar Kelimeler

Gastrointestinal Kanama, Skorlama Sistemi, Acil Servis, Komplikasyonlar

Proje Numarası

Yok

Kaynakça

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