Compare of AIMS 65 and Glasgow-Blatchford score for predicting clinical outcomes in patients with upper gastrointestinal bleeding in the emergency room
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摘要: 目的:比较AIMS65评分与Glasgow-Blatchford(GBS)评分对急诊抢救室上消化道出血患者临床不良事件的预测价值。方法:我们回顾性研究了2018年1月-2019年9月期间在我院急诊抢救室治疗的719例上消化道出血患者临床资料,根据不良事件发生率(输血治疗,手术/介入干预及死亡),比较AIMS65和Glasgow-Blatchford评分对患者预后的预测价值。使用受试者工作特征曲线(ROC)下面积对两个评分系统进行比较。结果:AIMS65评分与GBS评分评估不良事件发生率的ROC曲线下面积分别为0.75,0.74,差异无统计学意义(P=0.78);AIMS 65评分与GBS评分评估输血治疗的ROC曲线下面积分别为0.65,0.72,差异有统计学意义(P=0.0044);AIMS 65评分与GBS评分评估手术/介入干预的ROC曲线下面积分别为0.70、0.63,差异无统计学意义(P=0.071);AIMS65评分与GBS评分预测死亡的ROC曲线下面积分别为0.96,0.88,差异有统计学意义(P=0.034);AIMS65评分与GBS评分最佳临界值分别为2.5与12.5。结论:预测上消化道出血患者在抢救室不良事件发生率时AIMS 65评分与GBS评分相当,在预测死亡风险方面AIMS 65更佳,在输血治疗上GBS评分有更好预测价值。
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关键词:
- 急性上消化道出血 /
- AIMS65评分 /
- Glasgow-Blatchford评分 /
- 死亡率
Abstract: Objective: This study aimed to compare AIMS65 score and Glasgow-Blatchford score(GBS) in predicting clinical adverse outcomes in patients with upper gastrointestinal bleeding(UGIB) in emergency room.Methods: We retrospectively studied 719 patients with UGIB in the emergency room from January 2018 to September 2019 in our hospital. The AIMS 65 score and the GBS were used to stratify patients based on their bleeding risk. Compare their prediction value for adverse events, including blood transfusion, operation and death. The areas under the receiver operating characteristics curve(AUC) of two scoring systems were computed to compare their predictive power.Results: The AIMS 65(AUC 0.96) was superior to the GBS(AUC 0.88) in predicting mortality(P=0.034).The AUC value of the AIMS65 was not significantly different from that of the GBS in predicting of adverse events(0.75 vs. 0.74, P=0.78) and operation(0.70 vs. 0.63, P=0.070). The AUC of the AIMS65 and the GBS was performed respectively was 0.65 and 0.72, respectively, in predicting blood transfusion, with statistically significant(P=0.0044). The optimal cut-off value of the AIMS 65 and the GBS was 2.5 and 12.5, respectively.Conclusion: AIMS 65 and GBS were all acceptable for predicting clinical outcomes for UGIB in the emergency room. AIMS 65 was better in predicting mortality. GBS was better in predicting blood transfusion. -
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[1] 《中华内科学杂志》编委会,《中华医学杂志》编委会,《中华消化杂志》编委会.急性非静脉曲张性上消化道出血诊治指南(2018年,杭州)[J].中华医学杂志,2019,(8):571-578.
[2] Tham J,Stanley A.Clinical utility of pre-endoscopy risk scores in upper gastrointestinal bleeding[J].Expert Rev Gastroenterol Hepatol,2019,13(12):1161-1167.
[3] Custovic N,Husic-Selimovic A,Srsen N,et al.Comparison of Glasgow-Blatchford Score and Rockall Score in Patients with Upper Gastrointestinal Bleeding[J].Med Arch,2020,74(4):270-274.
[4] Oakland K.Risk stratification in upper and upper and lower GI bleeding:Which scores should we use?[J].Best Pract Res Clin Gastroenterol,2019,42-43:101613.
[5] 林凡榆,黄华,王家平等.上消化道出血临床评分系统的应用及研究进展[J].昆明医科大学学报,2019,40(8):120-125.
[6] Custovic N,Husic-Selimovic A,Srsen N,et al.Comparison of Glasgow-Blatchford Score and Rockall Score in Patients with Upper Gastrointestinal Bleeding[J].Med Arch,2020,74(4):270-274.
[7] 奚黎婷,朱锦舟,杨奕等.急性非静脉曲张性上消化道出血评分系统的研究进展[J].中国中西医结合消化杂志,2020,28(9):726-730.
[8] 孙宝妮,王海,裴红红,等.Blatchford评分在预测460例急诊上消化道出血病因中的价值研究[J].临床急诊杂志,2020,21(3):244-246.
[9] Brullet E,Garcia-Iglesias P,Calvet X,et al.Endoscopist's Judgment Is as Useful as Risk Scores for Predicting Outcome in Peptic Ulcer Bleeding:A Multicenter Study[J].J Clin Med,2020,9(2):.
[10] 苏争艳,孙超,蒋肸慧,等.三种评分系统在肝硬化食管胃底静脉曲张破裂出血患者风险评估中的应用[J].中华消化内镜杂志,2020,(2):105-106-107-108-109-110.
[11] 张倩倩,唐阳,彭琼.非静脉曲张上消化道出血患者危险分层评估中不同评分系统的应用[J].现代消化及介入诊疗,2020,25(3):357-360.
[12] Chandnani S,Rathi P,Udgirkar SS,et al.CLINICAL UTILITY OF RISK SCORES IN VARICEAL BLEEDING[J].Arq Gastroenterol,2019,56(3):286-293.
[13] Chang A,Ouejiaraphant C,Akarapatima K,et al.Prospective Comparison of the AIMS65 Score,Glasgow-Blatchford Score,and Rockall Score for Predicting Clinical Outcomes in Patients with Variceal and Nonvariceal Upper Gastrointestinal Bleeding[J].Clin Endosc,2021,54(2):211-221.
[14] Robertson M,Ng J,Abu Shawish W,et al.Risk stratification in acute variceal bleeding:Comparison of the AIMS65 score to established upper gastrointestinal bleeding and liver disease severity risk stratification scoring systems in predicting mortality and rebleeding[J].Dig Endosc,2020,32(5):761-768.
[15] 江贵军,吕菁君,魏捷,等.不同评分系统对急性上消化道出血继发心肌梗死的预测价值研究[J].临床急诊杂志,2020,21(11):853-860.
[16] Lu X,Zhang X,Chen H.Comparison of the AIMS65 score with the Glasgow-Blatchford and Rockall scoring systems for the prediction of the risk of in-hospital death among patients with upper gastrointestinal bleeding[J].Rev Esp Enferm Dig,2020,112(6):467-473.
[17] Hirai R,Shimodate Y,Minami M,et al.AIMS65 predicts prognosis of patients with duodenal ulcer bleeding;a comparison with other risk-scoring systems[J].Eur J Gastroenterol Hepatol,2020.
[18] Kim MS,Choi J,Shin WC.AIMS65 scoring system is comparable to Glasgow-Blatchford score or Rockall score for prediction of clinical outcomes for non-variceal upper gastrointestinal bleeding[J].BMC Gastroenterol,2019,19(1):136.
[19] Kita S,Shirai Y,Yoshida T,et al.Comparison of various risk scores for the prognosis of hemorrhagic upper gastrointestinal mucosal disorder[J].Int J Emerg Med,2020,13(1):41.
[20] Kawaguchi K,Isomoto H.Validation of AIMS65 to predict outcomes in acute variceal bleeding:Which risk scoring system outperforms in real practice?[J].Dig Endosc,2020,32(5):739-741.
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