Upper Gastrointestinal Hemorrhage: Validation of the Severity Score

Rangson Chaikitamnuaychok, Jayanton Patumanond

Abstract


Background: A simple scoring system was developed earlier to classify patients presenting with upper gastrointestinal hemorrhage into mild, moderates and severe. To validate the derived simple UGIH severity scoring system to another set of data obtained from consecutive patients.

Methods: The score was developed earlier from data of patients with UGIH in 2009 - 2010. The same scoring system was assigned to another set of data from patients of the following year. Classification of patients into 3 urgency levels reflecting their severity was compared. Performance similarity of the score in the two sets of data was tested with a chi-squared test for homogeneity. The ability of the score to discriminate mild patients from moderate/severe, and to discriminate severe patients from mild/moderate was identified and compared with analysis of area under the receiver operating characteristic curve (AuROC).

Results: Patients from the validation data were similar to those from the development data in overall aspects. The severity of UGIH and the score distribution in the two sets were similar. The score successfully classified patients in the validation data into 3 severity levels similar to the development data (P = 0.381, chi-squared for homogeneity), and similarly discriminated mild patients from moderate/severe patients (P = 0.360, AuROC analysis), and similarly discriminated severe patients from mild/moderate patients (P = 0.589, AuROC analysis)

Conclusion: The simple scoring scheme developed earlier to classify UGIH patients into 3 severity/urgency levels performed similarly in the validation data obtained from patients in the following year. Advantages of the scoring scheme should be tested when applied to patient care to assure clinical adoption into routine practice.




doi: http://dx.doi.org/10.4021/gr540w


Keywords


Clinical prediction rules; Scoring system; Screening; Upper gastrointestinal bleeding; Upper gastrointestinal hemorrhage; Validation

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