Universität zu Köln

Allo, Gabriel ORCID: 0000-0001-7568-7431, Buerger, Martin, Gillessen, Johannes, Kasper, Philipp, Franklin, Jeremy, Mueck, Vera, Nierhoff, Dirk, Steffen, Hans-Michael ORCID: 0000-0001-6562-3549, Goeser, Tobias and Schramm, Christoph (2022). Comparison of Pre-Endoscopic C-WATCH Score with Established Risk Assessment Tools in Patients with Upper Gastrointestinal Bleeding. Dig. Dis., 40 (6). S. 826 - 835. BASEL: KARGER. ISSN 1421-9875

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Abstract

Introduction: Use of risk scores for early assessment of patients with upper gastrointestinal bleeding (UGIB) is recommended by various guidelines. We compared Cologne-WATCH (C-WATCH) score with Glasgow-Blatchford score (GBS), Rockall score (RS), and pre-endoscopic RS (p-RS). Methods: Patients with UGIB between January and December 2017 were retrospectively analyzed for 30-day mortality and composite endpoints risk of complications and need for intervention using areas under the receiver-operating characteristics curve (AUROC). Subgroup analysis was conducted for patients with UGIB on admission and in-hospital UGIB. Results: A total of 252 patients were identified (67.5% men, mean age 63.8 +/- 14.9 years). In-hospital UGIB occurred in 49.6%. AUROCs for 30-day mortality, risk of complications, and need for intervention (not applicable to RS) were 0.684 (95% confidence interval [CI]: 0.606-0.763), 0.665 (95% CI: 0.594-0.735), and 0.694 (95% CI: 0.612-0.775) for C-WATCH score, 0.724 (95% CI: 0.653-0.796) and 0.751 (95% CI: 0.687-0.815) for RS, 0.652 (95% CI: 0.57-0.735), 0.653 (95% CI: 0.579-0.727), and 0.673 (95% CI: 0.602-0.745) for p-RS and 0.652 (95% CI: 0.572-0.732), 0.663 (95% CI: 0.592-0.734), and 0.752 (95% CI: 0.683-0.821) for GBS. RS outperformed pre-endoscopic scores in predicting risk of complications, while there were no significant differences between pre-endoscopic scores except GBS outperforming p-RS in predicting need for intervention. The subgroup analysis obtained similar results. Positive predictive values for patients with estimated low risk for all three endpoints (C-WATCH score <= 1, RS <= 2, p-RS <1, and GBS <= 1) were 89%, 69%, 78%, and 92%. Conclusion: C-WATCH score performed similar to the established pre-endoscopic risk scores in patients with UGIB regarding relevant patient-related endpoints with no significant differences between both the subgroups.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Allo, Gabriel UNSPECIFIED orcid.org/0000-0001-7568-7431 UNSPECIFIED Buerger, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Gillessen, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Kasper, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Franklin, Jeremy UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueck, Vera UNSPECIFIED UNSPECIFIED UNSPECIFIED Nierhoff, Dirk UNSPECIFIED UNSPECIFIED UNSPECIFIED Steffen, Hans-Michael UNSPECIFIED orcid.org/0000-0001-6562-3549 UNSPECIFIED Goeser, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Schramm, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-666812
DOI:	10.1159/000522121
Journal or Publication Title:	Dig. Dis.
Volume:	40
Number:	6
Page Range:	S. 826 - 835
Date:	2022
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1421-9875
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OUTPATIENT MANAGEMENT; GLASGOW BLATCHFORD; HEMORRHAGE; PREDICTION; MORTALITY; EPIDEMIOLOGY; GUIDELINE; SOCIETY; UPDATE Multiple languages Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66681