Nghiên cứu giá trị một số thang điểm trong tiên lượng chảy máu tiêu hóa trên không do tăng áp lực tĩnh mạch cửa ở bệnh nhân cao tuổi

The global aging population presents increasing challenges in managing age-related health conditions, among which non-variceal upper gastrointestinal bleeding (UGIB) is a significant cause of hospitalization and mortality in elderly patients. Accurate and timely prognostication is crucial for effective patient management, reducing complications, and improving outcomes in this vulnerable group. Existing prognostic scoring systems, such as Glasgow-Blatchford (GB), Rockall, and AIMS65, are widely used, but their specific utility and predictive value in elderly populations with non-variceal UGIB require further clarification. This study aims to evaluate the efficacy of these scoring systems in predicting the risk of rebleeding and in-hospital mortality in elderly patients with this specific condition.

Medical professionals, including gastroenterologists, geriatricians, emergency physicians, and internal medicine specialists, as well as clinical researchers interested in gastrointestinal bleeding and geriatric care.

Given the growing elderly population and the high morbidity and mortality associated with non-variceal upper gastrointestinal bleeding (UGIB) in this demographic, precise prognostic tools are essential for clinical decision-making. This prospective, cross-sectional descriptive study involved 192 elderly patients (aged ≥ 60) with non-variceal UGIB admitted to military hospitals. The research systematically calculated and compared the predictive values of the Glasgow-Blatchford (GB), clinical Rockall, and AIMS65 scoring systems for rebleeding and in-hospital mortality. Findings revealed that all three systems possessed predictive utility for rebleeding. However, the AIMS65 score demonstrated superior performance, exhibiting the best predictive value (AUC = 0.925) for rebleeding with a 100% sensitivity and 80.4% specificity at a cut-off of 2, significantly outperforming GB (AUC 0.837) and Rockall (AUC 0.815). For predicting in-hospital mortality, both AIMS65 (AUC 0.945) and GB (AUC 0.901) showed very good predictive values, with AIMS65 again demonstrating higher sensitivity (93.8%) and specificity (84.1%) at the same cut-off. These results underscore the substantial value of AIMS65 as a highly reliable and effective tool for assessing the risk of rebleeding and in-hospital mortality in elderly patients with non-variceal UGIB, strongly advocating for its adoption in clinical practice to guide management strategies and improve patient outcomes.