Clinical Endoscopy

  • 제55권2호
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  • Pages.240-247
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  • 2022
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
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Risk Stratification in Cancer Patients with Acute Upper GastrointestinalBleeding: Comparison of Glasgow-Blatchford, Rockall and AIMS65, and Development of a New Scoring System

  • Matheus Cavalcante Franco (Hospital Sirio-Libanes) ;
  • Sunguk Jang (Department of Gastroenterology and Hepatology, Cleveland Clinic) ;
  • Bruno da Costa Martins (Endoscopy Unit, Cancer Institute of the University of Sao Paulo) ;
  • Tyler Stevens (Department of Gastroenterology and Hepatology, Cleveland Clinic) ;
  • Vipul Jairath (Western University) ;
  • Rocio Lopez (Department of Gastroenterology and Hepatology, Cleveland Clinic) ;
  • John J. Vargo (Department of Gastroenterology and Hepatology, Cleveland Clinic) ;
  • Alan Barkun (Division of Gastroenterology, McGill University and the McGill University Health Centre) ;
  • Fauze Maluf-Filho (Endoscopy Unit, Cancer Institute of the University of Sao Paulo)
  • 투고 : 2021.03.28
  • 심사 : 2021.08.29
  • 발행 : 2022.03.30
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초록

Background/Aims: Few studies have measured the accuracy of prognostic scores for upper gastrointestinal bleeding (UGIB) among cancer patients. Thereby, we compared the prognostic scores for predicting major outcomes in cancer patients with UGIB. Secondarily, we developed a new model to detect patients who might require hemostatic care. Methods: A prospective research was performed in a tertiary hospital by enrolling cancer patients admitted with UGIB. Clinical and endoscopic findings were obtained through a prospective database. Multiple logistic regression analysis was performed to gauge the power of each score. Results: From April 2015 to May 2016, 243 patients met the inclusion criteria. The AIMS65 (area under the curve [AUC] 0.85) best predicted intensive care unit admission, while the Glasgow-Blatchford score best predicted blood transfusion (AUC 0.82) and the low-risk group (AUC 0.92). All scores failed to predict hemostatic therapy and rebleeding. The new score was superior (AUC 0.74) in predicting hemostatic therapy. The AIMS65 (AUC 0.84) best predicted in-hospital mortality. Conclusions: The scoring systems for prognostication were validated in the group of cancer patients with UGIB. A new score was developed to predict hemostatic therapy. Following this result, future prospective research should be performed to validate the new score.

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참고문헌

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