Endoscopy 2019; 51(04): S61
DOI: 10.1055/s-0039-1681350
ESGE Days 2019 oral presentations
Friday, April 5, 2019 14:30 – 16:30: GI bleeding Club C
Georg Thieme Verlag KG Stuttgart · New York

THE NEW INTERNATIONAL BLEEDING RISK SCORE SYSTEM IS A USEFUL PREDICTOR OF MORTALITY IN PATIENTS WITH NON-VARICEAL UPPER GASTROINTESTINAL BLEEDING

HS Moon
1   Department of Internal Medicine, Division of Gatroenterology, Chungnam National University Hospital, Daejeon, Korea, Republic of
,
MS Kim
1   Department of Internal Medicine, Division of Gatroenterology, Chungnam National University Hospital, Daejeon, Korea, Republic of
,
JH Park
1   Department of Internal Medicine, Division of Gatroenterology, Chungnam National University Hospital, Daejeon, Korea, Republic of
,
JS Kim
1   Department of Internal Medicine, Division of Gatroenterology, Chungnam National University Hospital, Daejeon, Korea, Republic of
,
SH Kang
1   Department of Internal Medicine, Division of Gatroenterology, Chungnam National University Hospital, Daejeon, Korea, Republic of
,
JK Sung
1   Department of Internal Medicine, Division of Gatroenterology, Chungnam National University Hospital, Daejeon, Korea, Republic of
,
HY Jeong
1   Department of Internal Medicine, Division of Gatroenterology, Chungnam National University Hospital, Daejeon, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

To validate the use of the new international bleeding score for prediction of mortality in patients with non-variceal upper gastrointestinal bleeding and to assess whether a high new score can predict re-bleeding or an extended hospital stay.

Methods:

This was a 5-year, single-center, retrospective study performed in Korea. Non-variceal upper gastrointestinal bleeding was assessed using the new international bleeding risk score, Rockall, AIMS65, GBS, and PNED scores. Scores for mortality were assessed by calculating the area under the receiver-operating characteristic curves (AUROC). Data regarding patients' characteristics, endoscopic evidence of bleeding, re-bleeding, duration of hospital stay, and mortality at day 30 were collected. The predictive value of factors for mortality at day 30 was identified using multivariate logistic regression analysis of variables identified by univariate logistic regression. A Chi-square test was used to further analyze the relationship between the high and the low new score group with reference to re-bleeding and duration of hospital stay.

Results:

Of 1000 hospital patients who presented with upper gastrointestinal bleeding, 905 patients with non-variceal bleeding were analyzed and 95 patients with variceal bleeding were excluded.

The new score is a weighted risk score based on the patients' ages, comorbidities and results of blood tests. The new score showed a higher discriminative ability compared to the other scores by AUROC (0.958, p < 0.000), when predicting mortality. A comparison of the high-risk new score and the low risk groups revealed significant differences in the duration of hospitalization (p = 0.000) and re-bleeding (p = 0.000).

Conclusions:

The new international bleeding score appears to be a better predictor of the 30-day mortality rate than the scores previously mentioned. Screening for high risk groups using the new score can predict mortality, long-term hospital admission and re-bleeding. Use of this scoring system can improve outcomes through appropriate management and intervention.