Multicentre comparison of the Glasgow Blatchford and Rockall scores in the prediction of clinical end-points after upper gastrointestinal haemorrhage

Stanley, A.J. et al. (2011) Multicentre comparison of the Glasgow Blatchford and Rockall scores in the prediction of clinical end-points after upper gastrointestinal haemorrhage. Alimentary Pharmacology and Therapeutics, 34(4), pp. 470-475. (doi: 10.1111/j.1365-2036.2011.04747.x) (PMID:21707681)

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Abstract

Background: The Glasgow Blatchford Score (GBS) is increasingly being used to predict intervention and outcome following upper gastrointestinal haemorrhage (UGIH). Aim: To compare the GBS with both the admission and full Rockall scores in predicting specific clinical end‐points following UGIH. Patients and methods: Data on consecutive patients presenting to four UK hospitals were collected. Admission history, clinical and laboratory data, endoscopic findings, treatment and clinical follow‐up were recorded. Using ROC curves, we compared the three scores in the prediction of death, endoscopic or surgical intervention and transfusion. Results: A total of 1555 patients (mean age 56.7 years) presented with UGIH during the study period. Seventy‐four (4.8%) died, 223 (14.3%) had endoscopic or surgical intervention and 363 (23.3%) required transfusion. The GBS was similar at predicting death compared with both the admission Rockall (area under ROC curve 0.804 vs. 0.801) and full Rockall score (AUROC 0.741 vs. 0.790). In predicting endo‐surgical intervention, the GBS was superior to the admission Rockall (AUROC 0.858 vs. 0.705; P < 0.00005) and similar to the full Rockall score (AUROC 0.822 vs. 0.797). The GBS was superior to both admission Rockall (AUROC 0.944 vs. 0.756; P < 0.00005) and full Rockall scores (AUROC 0.935 vs. 0.792; P < 0.00005) in predicting need for transfusion. Conclusions: Despite not incorporating age, the GBS is as effective as the admission and full Rockall scores in predicting death after UGIH. It is superior to both the admission and full Rockall scores in predicting need for transfusion, and superior to the admission Rockall score in predicting endoscopic or surgical intervention.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Blatchford, Dr Oli and Stanley, Dr Adrian and Gaya, Mr Daniel
Authors: Stanley, A.J., Dalton, H.R., Blatchford, O., Ashley, D., Mowat, C., Cahill, A., Gaya, D.R., Thompson, E., Warshow, U., Hare, N., Groome, M., Benson, G., and Murray, W.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Alimentary Pharmacology and Therapeutics
Publisher:Wiley
ISSN:0269-2813
ISSN (Online):1365-2036
Published Online:26 June 2011

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