ABSTRACT
Objective: This study aimed to compare the performances of the Glasgow-Blatchford Bleeding Score [GBS], pre-endoscopic Rockall score [PRS], complete Rockall score [CRS], and Cedars-Sinai Medical Center Predictive Index [CSMCPI] in predicting clinical outcomes in patients with upper gastrointestinal bleeding [UGIB]
Methods: Patients who were admitted to the emergency department because of UGIB and underwent endoscopy within the first 24 hour were included in this study. The GBS, PRS, CRS, and CSMCPI were propectively calculated. The performances of these scores were assessed using a receiver operating characteristic curve
Results: A total of 153 patients were included in this study. For the prediction of high-risk patients, area under the curve [AUC] was obtained for GBS [0.912], PRS [0.968], CRS [0.991], and CSMCPI [0.918]. For the prediction of rebleeding, AUC was obtained for GBS [0.656], PRS [0.625], CRS [0.701], and CSMCPI [0.612]. For the prediction of 30-day mortality, AUC was obtained for GBS [0.658], PRS [0.757], CRS [0.823], and CSMCPI [0.745]
Conclusion: These results suggest that effectiveness of CRS is higher than that of other scores in predicting high-risk patients, rebleeding and 30-day mortality in patients with UGIB
ABSTRACT
BACKGROUND/AIMS: We sought to examine whether the presence of gallstone disease (GD) in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD) is associated with liver fibrosis and histological nonalcoholic steatohepatitis (NASH) score. METHODS: We included 441 Turkish patients with biopsy-proven NAFLD. GD was diagnosed in the presence of sonographic evidence of gallstones, echogenic material within the gallbladder with constant shadowing and little or no visualization of the gallbladder or absence of gallbladder at ultrasonography, coupled with a history of cholecystectomy. RESULTS: Fifty-four patients (12.2%) had GD (GD+ subjects). Compared with the GD- subjects, GD+ patients were older, had a higher body mass index and were more likely to be female and have metabolic syndrome. However, GD+ patients did not have a higher risk of advanced fibrosis or definite NASH on histology. After adjustment for potential confounding variables, the prevalence of GD in NAFLD patients was not associated with significant fibrosis (> or =2) (odds ratio [OR], 1.06; 95% confidence interval [CI], 0.53 to 2.21; p=0.68) or definite NASH (OR, 1.03; 95% CI, 0.495 to 2.12; p=0.84). CONCLUSIONS: The presence of GD is not independently associated with advanced fibrosis and definite NASH in adult Turkish patients with biopsy-proven NAFLD.