Comparison of Rockall and Blatchford scores to assess outcome of patients with bleeding peptic ulcers after endoscopic therapy

Mu-Shien Lee, Chi-Liang Cheng, Nai-Jen Liu, Yung-Kuan Tsou, Jui-Hsiang Tang, Cheng-Hui Lin, Kai-Feng Sung, Ching-Song Lee
Hepato-gastroenterology 2013, 60 (128): 1990-7

BACKGROUND/AIMS: To determine the accuracy of Rockall and Blatchford scores for predicting outcome after endoscopic treatment in two groups of patients with bleeding peptic ulcers: those who initially presented with upper gastrointestinal (UGI) bleeding (Group A) and those who developed UGI bleeding during hospital treatment for another condition (Group B).

METHODOLOGY: A total of 593 patients who had had endoscopic treatment for bleeding peptic ulcers from January 2009 to July 2010 were divided into Groups A and B. Endoscopic therapy including monotherapy (thermal therapy or hemoclipping) and combination therapy was applied. The Blatchford and complete Rockall scores for the two subgroups were calculated. Predictive statistics for the use of the two scoring systems were then compared for Groups A and B.

RESULTS: Thirty-day re-bleeding and mortality rates increased with increased Rockall and Blatchford scores. Rockall scores were more accurate than the Blatchford scores for predicting mortality. However, neither the Rockall nor the Blatchford score could accurately predict recurrence of bleeding. When the results in Group B and Group A subgroups were compared, the average Rockall score for Group A was lower than that for Group B (5.6 vs. 6.3, p < 0.001).

CONCLUSIONS: In high-risk patients with peptic ulcer bleeding, the Rockall score can better predict 30-day mortality than can the Blatchford score; this was particularly true for Group B patients.

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