DGSG和Rockal评分对急性非静脉曲张性上消化道出血患者风险评估比较

Comparison of DGSG and Rockall Scoring System in Predictive Value of Death Risk of Acute Non-variceal Upper Gastrointestinal Bleeding

目的:比较DGSG评分和Rockall评分对急性非静脉曲张性上消化道出血(acute nonvariceal upper gastrointestinal bleeding,ANVUGIB)患者死亡风险的预测价值。方法:收集笔者所在医院2016年1月-2017年12月住院的ANVUGIB患者资料,将符合标准且资料完整者进行回顾性分析,分为死亡组和生存组,均应用DGSG、Rockall两个评分系统评分,通过绘制受试者工作特征曲线下面积(AUC)比较两者预测ANVUGIB患者30 d死亡风险能力。结果:共纳入479例ANVUGIB患者,死亡组22例,生存组457例。DGSG评分预测死亡的AUC为0.93[95%CI(0.90,0.97),P<0.05],Rockall评分预测死亡的AUC为0.88[95%CI(0.81,0.95),P<0.05]。结论:DGSG评分系统、Rockall评分系统均具有良好的预测ANVUGIB患者死亡风险的能力,DGSG评分优于Rockall评分,该评分系统客观全面,方便记忆,计算简单,适合临床医师使用,可在临床推广应用。

Objective:To compare the value of DGSG and Rockall scoring systems in predicting the death risk in patients with acute non-variceal upper gastrointestinal bleeding(ANVUGIB).Method:The retrospective analysis was implemented to the patients with ANVUGIB admitted from January 2016 to December 2017 in the Gastroenterology Department,and the patients were divided into the death group and the survival group.In addition,the DGSG and Rockall scoring systems were applied to evaluate the death risk in patients with ANVUGIB,and the area under the receiver operating characteristic(ROC)curve was employed to compare the predictive value of the two scoring systems for the death risk of ANVUGIB patients.Result:In this study,a total of 479 patients with ANVUGIB were included,22 patients in the death group and 457 patients in the survival group.The AUC score predicted by DGSG was 0.93[95%CI(0.90,0.97),P<0.05],and the AUC score predicted by Rockall was 0.88[95%CI(0.81,0.95),P<0.05].Conclusion:The DGSG scoring system and Rockall scoring system have a good ability to predict the risk of death of ANVUGIB patients,and DGSG is superior to Rockall.This scoring system is objective and comprehensive,convenient to memorize,simple to calculate,suitable for clinical physicians,and can be used in clinical promotion.