Tianjin Med J ›› 2017, Vol. 45 ›› Issue (4): 423-427.doi: 10.11958/20161472

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The values of Rockall, Blatchford and AIMS65 scoring systems in the diagnosis and treatment of patients with acute upper gastrointestinal bleeding

LIU Hui-ling1, LUO Yan1△, LI Chang-ping2, MEI Mei1, CHEN Jing1, SU Fang1, ZHANG Yan1, CHEN Yan-li1   

  1. 1 Department of Gastroenterology, Tianjin Haihe Hospital, Tianjin 300350, China; 2 School of Public Health, Tianjin Medical University
  • Received:2016-12-06 Revised:2017-03-07 Published:2017-04-15 Online:2017-04-15
  • Contact: Corresponding Author E-mail:tjhhnk@163.com E-mail:tjhhnk@163.com

Abstract: Objective To compare the predictive values of Rockall, Blatchford and AIMS65 scoring systems in the prognosis of patients with acute upper gastrointestinal bleeding (AUGIB). Methods A total of 130 patients with AUGIB in our hospital were enrolled in this study from August 2014 to August 2016 . Three kinds of scoring systems including Rockall, Blatchford and AIMS65 were used to evaluate the risk classification of the patients. Patients were followed up for 2 months. The incidence rates of re-bleeding and death within 2 months after admission were observed. Data of prognosis in patients with AUGIB were compared between the three scoring systems in the prognosis of patients with AUGIB, including the risk classification and the prediction accuracy of re-bleeding and death. Results There were no significant differences in the re- bleeding rate and fatality rate between the groups divided by Rockall and Blatchford scoring systems (P>0.05). According to the grouping results of AIMS65 scoring system, the re-bleeding rate of low-risk group was lower than that in high risk group (1.45% vs. 13.11%, P=0.01), but there was no significant difference in fatality rate between the two groups (P>0.05). The values of area under the curve (AUC) of predicting re- bleeding rates by using Rockall, Blatchford and AIMS65 scoring systems were 0.625 8, 0.691 0, and 0.724 1, and the values of AUC of predicting fatality rates were 0.703 1, 0.796 9, and 0.703 1 by using receiver operating characteristic curve (ROC) analysis. There were no significant differences between them (P>0.05). The values of AUC of predicting re-bleeding rates by using the risk grading calculation by Rockall, Blatchford and AIMS65 scoring systems were 0.618 9, 0.613 9 and 0.725 4 (P>0.05). But the values of AUC of predicting fatality rates were 0.621 1, 0.664 1 and 0.769 5 (P<0.01). Conclusion The operation method of AIMS65 scoring system is simple and convenient, which is applicable to a wide range of patients with AUGIB. In the prediction of re-bleeding and mortality, AIMS65 scoring system has high accuracy and stability, which is worthy of promoting in clinical application.

Key words: gastrointestinal hemorrhage, prognosis, diagnostic techniques, digestive system, program evaluation, Rockall scoring, Blatchford scoring, AIMS65 scoring