Han DP, Gou CQ, Ren XM. Predictive utility of the Rockall scoring system in patients suffering from acute nonvariceal upper gastrointestinal hemorrhage. World J Gastrointest Surg 2024; 16(8): 2620-2629 [PMID: 39220082 DOI: 10.4240/wjgs.v16.i8.2620]
Corresponding Author of This Article
De-Ping Han, BMed, Nurse, Department of Emergency, Chengyang District People’s Hospital, No. 600 Changcheng Road, Chengyang District, Qingdao 266109, Shandong Province, China. 17806231167@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2024; 16(8): 2620-2629 Published online Aug 27, 2024. doi: 10.4240/wjgs.v16.i8.2620
Predictive utility of the Rockall scoring system in patients suffering from acute nonvariceal upper gastrointestinal hemorrhage
De-Ping Han, Cai-Qian Gou, Xin-Mian Ren
De-Ping Han, Cai-Qian Gou, Xin-Mian Ren, Department of Emergency, Chengyang District People’s Hospital, Qingdao 266109, Shandong Province, China
Author contributions: Han DP designed the experiments, conducted clinical data collection, statistical analysis, wrote the original manuscript and revised the paper; Gou CQ and Ren XM performed postoperative follow-up and recorded the data; All authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Chengyang District People’s Hospital.
Informed consent statement: The Ethics Committee agrees to waive informed consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: De-Ping Han, BMed, Nurse, Department of Emergency, Chengyang District People’s Hospital, No. 600 Changcheng Road, Chengyang District, Qingdao 266109, Shandong Province, China. 17806231167@163.com
Received: June 17, 2024 Revised: July 15, 2024 Accepted: July 22, 2024 Published online: August 27, 2024 Processing time: 60 Days and 3.6 Hours
Abstract
BACKGROUND
Acute non-variceal upper gastrointestinal bleeding (ANVUGIB) represents a significant clinical challenge due to its unpredictability and potentially severe outcomes. The Rockall risk score has emerged as a critical tool for prognostic assessment in patients with ANVUGIB, aiding in the prediction of rebleeding and mortality. However, its applicability and accuracy in the Chinese population remain understudied.
AIM
To assess the prognostic value of the Rockall risk score in a Chinese cohort of patients with ANVUGIB.
METHODS
A retrospective analysis of 168 ANVUGIB patients’ medical records was conducted. The study employed statistical tests, including the t-test, χ2 test, spearman correlation, and receiver operating characteristic (ROC) analysis, to assess the relationship between the Rockall score and clinical outcomes, specifically focusing on rebleeding events within 3 months post-assessment.
RESULTS
Significant associations were found between the Rockall score and various clinical outcomes. High Rockall scores were significantly associated with rebleeding events (r = 0.735, R2 = 0.541, P < 0.001) and strongly positively correlated with adverse outcomes. Low hemoglobin levels (t = 2.843, P = 0.005), high international normalized ratio (t = 3.710, P < 0.001), active bleeding during endoscopy (χ2 = 7.950, P = 0.005), large ulcer size (t = 6.348, P < 0.001), and requiring blood transfusion (χ2 = 6.381, P = 0.012) were all significantly associated with rebleeding events. Furthermore, differences in treatment and management strategies were identified between patients with and without rebleeding events. ROC analysis indicated the excellent discriminative power (sensitivity: 0.914; specificity: 0.816; area under the curve: 0.933; Youden index: 0.730) of the Rockall score in predicting rebleeding events within 3 months.
CONCLUSION
This study provides valuable insights into the prognostic value of the Rockall risk score for ANVUGIB in the Chinese population. The results underscore the potential of the Rockall score as an effective tool for risk stratification and prognostication, with implications for guiding risk-appropriate management strategies and optimizing care for patients with ANVUGIB.
Core Tip: This retrospective clinical study aimed to assess the prognostic value of the Rockall risk score in a Chinese cohort of patients with acute non-variceal upper gastrointestinal bleeding (ANVUGIB). The conclusion of this study provides valuable insights into the prognostic value of the Rockall risk score for ANVUGIB in the Chinese population. The results underscore the potential of the Rockall score as an effective tool for risk stratification and prognostication, with implications for guiding risk-appropriate management strategies and optimizing care for patients with ANVUGIB.
