Comparison of various risk scores for the prognosis of hemorrhagic upper gastrointestinal mucosal disorder

• Main Authors: Shinya Kita, Yasuyuki Shirai, Tomoharu Yoshida, Kei Shiraishi, Ayako Nakamura, Michitaka Kawano, Yoshihiro Kinoshita, Tatsuya Noguchi, Syunsuke Ito
• Format: Article
• Language: English
• Published: BMC 2020-07-01
• Series: International Journal of Emergency Medicine
• Subjects: AIMS65 score; Charlson Comorbidity Index; Prognosis; Upper gastrointestinal bleeding; Upper gastrointestinal mucosal disorder
• Online Access: http://link.springer.com/article/10.1186/s12245-020-00293-x

Abstract Background Various risk scores have been proposed that are useful for the management of upper gastrointestinal bleeding (UGIB), which is an important disease in emergency medicine. Few studies have examined the usefulness of Charlson Comorbidity index (CCI) in this disease, which evaluates the patient’s general condition by scoring the patient’s underlying disease. There have been no studies investigating the efficacy of CCI compared to other risk scores in the management of UGIB requiring endoscopic hemostasis. Methods In addition to the Glasgow-Blatchford score, AIMS65 score, and Rockall score, we investigated the efficacy of the outcome prediction obtained by the original CCI and the updated CCI, scored only with respect to the underlying disease. We also examined the cutoff value when using the risk score. This retrospective study included 265 patients with hemorrhagic upper gastrointestinal mucosal lesions who underwent emergency endoscopic hemostasis during a 6-year period between 2011 and 2016 in our hospital. Results The updated CCI and AIMS65 score correlated with prognosis in multivariate analysis (p = 0.002 and p = 0.003, respectively). In clinical practice, the prognosis might be worse if both updated CCI and AIMS65 score were 3 point or more. Conclusion In addition to the AIMS65 score, the updated CCI can be a useful tool for managing upper gastrointestinal mucosal disorder bleeding that requires endoscopic hemostasis.