The Application Value Of Rockall,Blatchford And AIMS65 Scoring System In Patients With Acute Non-varices Upper Gastrointestinal Bleeding Of Different Causes

Objective Further understanding of the ability of the Rockall,Blatchford and AIMS65 scores to predict prognosis in patients with bleeding peptic and non-bleeding peptic ulcers.Methods The study subjects selected for this study were 135 patients with upper gastrointestinal bleeding in our hospital,who were hospitalized from January 2019 to June 2021,and none of whom had varicose veins as the cause of their disease.,and the clinical data of each patient（including general information of patients,three scoring systems）were recorded.required clinical data,etiological diagnosis,main treatment conditions and patient prognosis),the patients were divided into peptic ulcer group and non-peptic ulcer group according to the cause of bleeding,and the Rockall,Blatchford and AIMS65 scores of each patient were calculated,and conduct risk stratification,record clinical interventions（blood transfusion,endoscopic therapy,interventional therapy and surgery）,rebleeding,and death under different risk stratifications,and study Rockall,Blatchford and AIMS65 scoring systems for clinical interventions in patients with ANVUGIB,rebleeding and predictive value of death.Results Among the 135 bleeding patients,111 were male and 24 were female,6 patients（6.78%）were accompanied by heart failure,and 10 patients（7.41%）were associated with liver disease.89 patients did not require further clinical intervention（blood transfusion,endoscopic therapy,interventional therapy and surgery,etc.）,and no rebleeding and death occurred;43 patients required at least one clinical intervention,of which37 were blood transfusion,endoscopic therapy 7 cases,3 cases of interventional treatment,2 cases of surgery;14 cases of rebleeding occurred;7 cases of patients died.In the ulcer group and the non-ulcer group,the Blatchford and Rockall scoring system high-risk group had a higher intervention rate than the low-risk group（P<0.05）,but there was no significant difference in rebleeding rate and mortality（P>0.05）.The intervention rate,rebleeding rate and mortality rate in the high-risk group of AIMS65 scoring system were higher than those in the low-risk group（P<0.05）.The AUCs for rebleeding were 0.718,0.715,and 0.862,and the AUCs for predicting death were 0.903,0.817,and 0.874,respectively.The AUCs of GBS,Rockall,and AIMS65 scores in the non-ulcer group for predicting intervention were 0.775,0.890,and 0.725,respectively.The AUCs for rebleeding were 0.831,0.824,and 0.892,and the AUCs for predicting death were 0.930,0.895,and 0.895,respectively.Conclusion 1.Among the many causes of ANVUGIB,peptic ulcer,gastrointestinal tumor,cardia mucosa tear,and acute erosive hemorrhagic gastritis are the most common causes of bleeding.2.GBS,Rockall and AIMS65 scores have certain predictive value for clinical intervention,rebleeding and death in patients with ANVUGIB of different etiologies.3.AIMS65 score was the best predictor of rebleeding outcome in all etiology group,GBS score was the best predictor of death outcome in all etiology group,GBS score was the best predictor of intervention outcome in peptic ulcer group,Rockall score was best in non-digestive ulcer group.Patients in the ulcer group had the best predictors of intervention outcomes.