Comparison Of The Predictive Value Of ABC,GBS And FRs Scoring Systems In The Intervention And Prognosis Of Elderly Patients With ANVUGIB

Objective:To evaluate the predictive value of ABC(Age,blood tests,comorbidities)score,Full Rockall score(fRS)and Glasgow-Blatchford score(GBS)system for endoscopic and surgical treatment,blood transfusion treatment,rebleeding and death,and in the elderly patients with acute non-varicose upper gastrointestinal bleeding(ANVUGIB).Methods:The data were collected of 556 elderly patients(≥65 years old)with ANVUGIB in China-Japan Union Hospital Affliated to Jilin University from January 2017 to December 2020.According to whether the patients receives endoscopic-or-surgical treatment and blood-transfusion treatment,die or rebleeding,the patients were divided into endoscopic-or-surgical group,drug threapy group,blood-transfusion group,and non-bleeding-transfusion group,die group or live group,rebleeding group or no rebleeding group,and Each patient was scored using the ABC,GBS and fRS scoring systems.The area under the receiver operating characteristic curve(AUC)was used to compare the predictive value of the three scoring systems for endoscopic or surgical treatment,blood transfusion,death and rebleeding in the elderly ANVUGIB patients.Results:Among 556 patients,153 patients have accepted endoscopic or surgical treatment,and 403 patients have accepted drug-treated.The scores of ABC、GBS and f Rs were(8.14±2.86)、(8.65±3.62)and(5.44±1.63)points in endoscopic or surgical treatment group,(5.24±2.23)、(7.88±3.60)and(2.88±1.28)points in drug-treated group(All p<0.05).Among 556 patients,260 patients have accepted transfusion treatment,and 296 patients have accepted non-transfusion treatment.The scores of ABC,GBS and fRS were(6.89±2.81),(9.76±2.64)and(4.01±1.94)points in transfusion group,and(5.29±2.45),(6.63±3.73)and(3.23±1.53)points in non-transfusion group(All p<0.05).ROC analysis showed that GBS score was superior to ABC score and fRS score in predicting blood transfusion treatment(0.740 and0.665,0.608;p<0.05);FRS score is superior to ABC score in predicting endoscopic or surgical treatment(0.888 and 0.791;p <0.05);The predictive value of ABC score for rebleeding is obviously better than GBS score(0.714 and 0.614;p<0.05);ABC score is superior to GBS and FRS in predicting death(0.892 and 0.736,0.830;p<0.05).Conclusion:1.The GBS score has a high predictive value for guiding clinical blood transfusion.2.The FRS score was highly predictive of the need for endoscopic or surgical intervention.3.The predictive value of ABC scoring system for rebleeding was significantly better than that of GBS scoring system.4.The ABC score system had a high predictive value for death.