四种非静脉曲张上消化道出血危险性评分系统的对比分析

目的探讨四种非静脉曲张性上消化道出血的危险性评分系统(Rockall再出血危险积分、Cedars-Sinai Medical Center预后指数、Blatchford入院危险性计分、The Baylor出血积分)对于已确定的非静脉曲张性上消化道出血的病人中再出血情况的预测能力。方法选取2002年-2007年消化内科收治的消化道出血病人753例,以四种危险性评分系统分别评分后,行卡方拟和优度检验检测数据分布的合理性,后计算受试者工作特性曲线(ROC曲线)下面积。结果四种评分系统的ROC曲线下面积分别为:Rockall再出血危险积分0.681(P0.01,95%CI:0.638-0.723),Cedars-Sinai Medical Center预后指数0.685(P0.01,95%CI:0.639-0.731),Blatchford入院危险性计分0.886(P0.01,95%CI:0.857-0.916),The Baylor出血积分0.737(P0.01,95%CI:0.95-0.779)。结论①四种评分系统均对再出血有预测性。②Blatchford入院危险性计分更适用于门诊及急诊。

Comparison of four different risk score systems in non-variceal upper gastrointestinal bleeding

Objective Tocompare the efficacy of 4 risk scoring systems (the Rockall's risk score system,Cedars-Sinai Medical Centre Predictive index,Blatchford risk score and the Baylor College score system) previously proposed to be predictive of rebleeding after upper gastrointestinal bleeding in patients with nonvariceal upper gastrointestinal bleeding. Methods We calculated the values of four scores for 753 patients who underwent endoscopy after non-variceal upper gastrointestinal haemorrhage during the years 2002 ...