Glasgow-Blatchford versus Rockall Scoring Systems for Predicting Outcomes of Patients with Upper Gastrointestinal Bleeding

Abstract

Abstract Acute upper gastrointestinal bleeding is a common emergency and potentially fatal health problem that associated with high mortality and morbidity. Gastrointestinal endoscopy can identify the cause of bleeding and remains the cornerstone of diagnosis and therapy in gastrointestinal bleeding. Aim: The aim of this study is to compare between the Glasgow-Blatchford score and Rockall score in predicting the clinical outcomes of patients with upper gastrointestinal bleeding during hospitalization. Study design: Retrospective observational cohort research design was used to conduct this study. Setting: This study was conducted in the medicine department 1 and 2 at medical hospital affiliated to Ain Shams University Hospitals, Cairo, Egypt. Subjects: Purposive sample of 95 adult patients who were admitted to the previously mentioned settings from October 2020 to March 2021 were included in the study. Data collection tools: (1) Patients' Clinical Outcomes Assessment Questionnaire, (2) The Glasgow-Blatchford Scale, (3) The pre-endoscopic Rockall Score. Results: Regarding re-bleeding prediction, (AUC for GBS= 0.573, RS 0.534). As for mortality prediction, GBS was similar to RS (AUC 0.754 and 0.744 respectively). Regarding need for blood transfusion (AUC for GBS= 0.868 and 0.691 for RS), prediction of need for endoscopic intervention revealed that GBS was superior to RS (AUC 0.785 and 0.675 respectively). In terms of length of hospital stay, GBS and RS were quietly equivalent (AUC 0.654 and 0.657 respectively). Conclusion: The study concluded that there was no statistically significant difference between the Glasgow Blatchford Score and pre-endoscopic Rockall Score in predicting accuracy of clinical outcomes for patients with upper gastrointestinal bleeding. Recommendations: It is recommended that the pre-endoscopic Glasgow Blatchford Score and Rockall Score are considered useful tools that can be safely used to predict clinical outcomes of patients with gastrointestinal bleeding.