Comparison of Several Clinical Scoring Systems in Predicting the Outcome of Variceal Bleeding

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Year : 2025 | Volume : 15 | Issue : 02 | Page :
    By

    Jong Nam-Hun,

  • Kim Song-Hwan,

  • Hwang Pyong-Song,

  • Kim Hye-Song,

  • Song Ye-Ok,

  • Yu Nam,

  • Hyon Mi-Hwa,

  1. Doctor, Department of Medical Science, Pyongyang University of Medical Sciences,, Pyongyang, Democratic People’s Republic of Korea
  2. Doctor, Department of Medical Science, Pyongyang University of Medical Sciences,, Pyongyang, Democratic People’s Republic of Korea
  3. Researcher, Department of Medical Science, Pyongyang University of Medical Sciences,, Pyongyang, Democratic People’s Republic of Korea
  4. Researcher, Department of Medical Science, Pyongyang University of Medical Sciences,, Pyongyang, Democratic People’s Republic of Korea
  5. Doctor, Department of Medical Science, Pyongyang University of Medical Sciences,, Pyongyang, Democratic People’s Republic of Korea
  6. Researcher, Department of Medical Science, Pyongyang University of Medical Sciences,, Pyongyang, Democratic People’s Republic of Korea
  7. Doctor, Department of Medical Science, Pyongyang University of Medical Sciences,, Pyongyang, Democratic People’s Republic of Korea

Abstract

Background: Stratification of variceal bleeding patients into high-risk and low-risk group is very important to guide them through the suitable clinical pathway and to save the medical costs. We purposed to find out the best scoring system in the prediction of rebleeding and death after variceal bleeding by comparing four clinical scoring systems(clinical Rockall score, complete Rockall score, AIMS65 score, Child-Pugh score) which seemed to be applicable and simple. Method: We prospectively studied 179 patients who admitted to the Pyongyang University of Medical Sciences Hospital with the diagnosis of variceal bleeding since Jan, 2015 to April, 2019. By comparing demographic, clinical, laboratorial, instrumental and therapeutic parameters between rebleeding group and non-rebleeding group and between dead group and survived group, predictive factors were selected. We used ROC(receiver operating characteristics) curves to arrange the utility orders of the scores in predicting rebleeding and death. Result: Parameters correlative with rebleeding were patient’s consciousness(hepatic encephalopathy), hypovolemic shock, hyperpnea, and WBC count, INR increase, severity of ascites, endoscopic finding of recent bleeding, and early transfusion.(P<0.05) Parameters related to death were age, consciousness(hepatic encephalopathy), hypovolemic shock, hyperpnea, anemia of conjunctiva, sclerotic jaundice, vascular spider, WBC increase, AST(aspartate transaminase) increase, hyperbilirubinemia, hypoalbuminemia, INR increase, severity of ascites, endoscopic presence of recent bleeding, and early rebleeding.(P<0.05) AUROCs of clinical Rockall score, complete Rockall score, AIMS65 score, Child-Pugh score in rebleeding prediction were 0.643, 0.709, 0.659, 0.612 and optimal cut-off points were 2, 3, 1, 7, respectively. Testing these cut-off points refused the utility of AIMS65 score and Child-Pugh score in rebleeding prediction. AUROCs of clinical Rockall score, complete Rockall score, AIMS65 score, Child-Pugh score in mortality prediction were 0.716, 0.795, 0.891, 0.834 and optimal cut-off points were 3, 4, 2, 9, respectively. Conclusion: Complete Rockall score is the best in rebleeding prediction of variceal bleeding, and AIMS65 score is the best in mortality prediction.

Keywords: Variceal bleeding, risk score, Rockall score, AIMS65, Child-Pugh classification, rebleeding, mortality

[This article belongs to Research and Reviews: A Journal of Medicine ]

How to cite this article:
Jong Nam-Hun, Kim Song-Hwan, Hwang Pyong-Song, Kim Hye-Song, Song Ye-Ok, Yu Nam, Hyon Mi-Hwa. Comparison of Several Clinical Scoring Systems in Predicting the Outcome of Variceal Bleeding. Research and Reviews: A Journal of Medicine. 2025; 15(02):-.
How to cite this URL:
Jong Nam-Hun, Kim Song-Hwan, Hwang Pyong-Song, Kim Hye-Song, Song Ye-Ok, Yu Nam, Hyon Mi-Hwa. Comparison of Several Clinical Scoring Systems in Predicting the Outcome of Variceal Bleeding. Research and Reviews: A Journal of Medicine. 2025; 15(02):-. Available from: https://journals.stmjournals.com/rrjom/article=2025/view=212382


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Regular Issue Subscription Original Research
Volume 15
Issue 02
Received 25/02/2025
Accepted 22/03/2025
Published 05/06/2025
Publication Time 100 Days
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