Comparison of the National Early Warning Score+Lactate score with the pre-endoscopic Rockall, Glasgow-Blatchford, and AIMS65 scores in patients with upper gastrointestinal bleedingopen access
- Authors
- Kim, Daejin; Jo, Sion; Lee, Jae Baek; Jin, Youngho; Jeong, Taeoh; Yoon, Jaechol; Park, Bo young
- Issue Date
- Dec-2018
- Publisher
- 대한응급의학회
- Keywords
- Bleeding; Gastrointestinal; Lactate; Mortality; Risk
- Citation
- Clinical and Experimental Emergency Medicine, v.5, no.4, pp.219 - 229
- Indexed
- KCI
- Journal Title
- Clinical and Experimental Emergency Medicine
- Volume
- 5
- Number
- 4
- Start Page
- 219
- End Page
- 229
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/148729
- DOI
- 10.15441/ceem.17.268
- ISSN
- 2383-4625
- Abstract
- Objective: We compared the predictive value of the National Early Warning Score+Lactate (NEWS+L) score with those of other parameters such as the pre-endoscopic Rockall score (PERS), Glasgow-Blatchford score (GBS), and albumin, international normalized ratio, altered mental status, systolic blood pressure, age older than 65 years score (AIMS65) among patients with upper gastrointestinal bleeding (UGIB).
Methods: We conducted a retrospective study of patients with UGIB during 2 consecutive years. The primary outcome was the composite of in-hospital death, intensive care unit admission, and the need for ≥5 packs of red blood cell transfusion within 24 hours.
Results: Among 530 included patients, the composite outcome occurred in 59 patients (19 in-hospital deaths, 13 intensive care unit admissions, and 40 transfusions of ≥5 packs of red blood cells within 24 hours). The area under the receiver operating characteristic curve of the NEWS+L score for the composite outcome was 0.76 (95% confidence interval, 0.70 to 0.82), which demonstrated a significant difference compared to PERS (0.66, 0.59-0.73, P=0.004), but not to GBS (0.70, 0.64-0.77, P=0.141) and AIMS65 (0.76, 0.70-0.83, P=0.999). The sensitivities of NEWS+L scores of 3 (n=34, 6.4%), 4 (n=92, 17.4%), and 5 (n=171, 32.3%) were 100%, 98.3%, and 96.6%, respectively, while the sensitivity of an AIMS65 score of 0 (n=159, 30.0%) was 91.5%.
Conclusion: The NEWS+L score showed better discriminative performance than the PERS and comparable discriminative performance to the GBS and AIMS65. The NEWS+L score may be used to identify low-risk patients among patients with UGIB.
- Files in This Item
-
- Appears in
Collections - 서울 의과대학 > 서울 예방의학교실 > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/148729)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.