What type of study is this?

September 10, 2025Open Access

Predictive Utility of Pre- and Post-Endoscopic Risk Scores and Hemodynamic Indexes in Acute Upper Gastrointestinal Bleeding in the Emergency Department

BSBedriye Müge SönmezUniversity of Health Science EKElif Hamzaçebioğlu KayışoğluSağlık Bilimleri Üniversitesi GAGülşen AkçayZübeyde Hanim Maternity Hospital

Key Points

Higher risk scores were linked to endoscopic intervention, emphasizing their prognostic value.
Statistical significance was found for various risk scores in predicting recurrent hemorrhage and mortality.
The shock index emerged as relevant primarily for assessing transfusion needs in patients with bleeding.
AIMS65 was deemed particularly valuable for risk stratification in the emergency department context.

Abstract

There is a controversy about risk scores for risk stratification of acute upper gastrointestinal bleeding (AUGIB) in the emergency department (ED). This study aimed to compare the prognostic utility of UGIB scores with perfusion index (PI) and shock index (SI) in these patient groups in the ED. A prospective cross-sectional study was conducted on a convenience sample of patients with AUGIB who were admitted to the ED of a tertiary care hospital. Areas under the receiver operating characteristic curve (AUROC) were used to evaluate the predictive performance of pre- and post-endoscopic risk scores, as well as hemodynamic indexes (PI and SI), in terms of composite endpoints. Rockall Score (RS), Cedars Sinai Medical Centre Predictive Index (CSMCPI), Progetto nazionale emorragia digestiva score (PNED), Glasgow Blatchford Score (GBS), and albumin, international normalized ratio, mental status, systolic blood pressure, age ≥65 years score (AIMS65) were significantly higher for endoscopic intervention (p=0.002, p<0.001, p=0.001, p=0.002, p=0.004, respectively). RS, Cedarsiani, PNED, and GBS were significantly higher in hospitalized patients (p = 0.001, p < 0.001, p = 0.021, p = 0.002, respectively). RS, PNED, and AIMS65 scores were significantly higher for recurrent hemorrhage (p = 0.019, p = 0.005, p = 0.008, respectively). RS, Baylor Bleeding Score (BBS), Cedarsinai, PNED, and AIMS65 were significantly higher for mortality (p = 0.01, p = 0.013, p = 0.026, p = 0.005, p = 0.003, respectively). SI was statistically significant only for the transfusion need of patients (p = 0.019). AIMS-65 seems to be more valuable and feasible than the others in the ED. Hemodynamic indexes should be used in conjunction with risk scores.

Ask AI

Helpful

Bookmark

View Full Paper