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상부위장관 출혈 환자에서 진행성 출혈을 예측하기 위한 Blatchford score 및Pre-rockall score의 유용성

Other Titles
 Validation of the Glasgow-Blatchford score and the Pre-endoscopic Rockall Score for Predicting Active Gastrointestinal Bleeding in Emergency Department Patients with Suspected Upper Gastrointestinal Bleeding 
Authors
 이동우  ;  이혜선  ;  유제성  ;  박유석  ;  정성필 
Citation
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지), Vol.25(6) : 645-652, 2014 
Journal Title
 Journal of the Korean Society of Emergency Medicine  (대한응급의학회지) 
ISSN
 1226-4334 
Issue Date
2014
Abstract
PURPOSE: The aim of this study was to validate the Glasgow-Blatchford score and the pre-endoscopic Rockall score to assess their ability to predict the presence of active bleeding in emergency department patients with suspected upper gastrointestinal bleeding. METHODS: We reviewed and extracted data from electronic medical records on patients presenting with a suspicion of acute upper gastrointestinal bleeding at our emergency department from January 1, 2012 to December 31, 2012. For each patient we calculated the Glasgow-Blatchford score and the pre-endoscopic Rockall score. Discriminative ability of the scoring systems for predicting active bleeding was evaluated by receiver operator characteristic (ROC) curve analysis. RESULTS: We identified 636 patients with upper gastrointestinal bleeding. There were 118 (18.6%) patients with active bleeding and 520 (81.8%) patients with need for intervention. The ROC curve analysis showed poor discriminative ability of the Glasgow-Blatchford score and the pre-endoscopic Rockall score for determining the presence of active bleeding (area under the curve (AUC)=0.546, 95% confidence interval (CI) 0.490-0.602 vs. 0.576, 95% CI 0.523-0.630; p=0.34). The sensitivity and the specificity of the two scoring systems were suboptimal. However, the Glasgow-Blatchford score outperformed the pre-endoscopic Rockall score in predicting the need for clinical intervention (AUC=0.867, 95% CI 0.831-0.903 vs. 0.698, 95% CI 0.643-0.754; p<0.001). CONCLUSION: The Glasgow-Blatchford score was superior in predicting the need for intervention in emergency department patients with suspected gastrointestinal hemorrhage. However, these clinical decision rules may be insufficient to predict the presence of active bleeding.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
박유석(Park, Yoo Seok) ORCID logo https://orcid.org/0000-0003-1543-4664
유제성(You, Je Sung) ORCID logo https://orcid.org/0000-0002-2074-6745
이혜선(Lee, Hye Sun) ORCID logo https://orcid.org/0000-0001-6328-6948
정성필(Chung, Sung Pil) ORCID logo https://orcid.org/0000-0002-3074-011X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138932
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