Predictive utility of the Rockall scoring system in patients suffering from acute nonvariceal upper gastrointestinal hemorrhage

Table 1 Patient characteristics, n (%)

Parameter	Without rebleeding group (n = 87)	Rebleeding group (n = 81)	t/χ2	P value
Age (years)	52.84 ± 8.15	54.15 ± 7.48	1.087	0.279
Gender (M/F)	35 (40.23)/52 (59.77)	37 (45.68)/44 (54.32)	0.310	0.577
BMI (kg/m2)	23.39 ± 1.31	23.65 ± 1.23	1.283	0.201
Smoking history (Yes/No)	11 (12.64)/76 (87.36)	10 (12.35)/71 (87.65)	0.000	1.000
Alcohol history (Yes/No)	20 (22.99)/67 (77.01)	19 (23.46)/62 (76.54)	0.000	1.000
Hypertension (Yes/No)	9 (10.34)/78 (89.66)	9 (11.11)/72 (88.89)	0.000	1.000
Diabetes (Yes/No)	7 (8.05)/80 (91.95)	6 (7.41)/75 (92.59)	0.000	1.000
Hyperlipidemia (Yes/No)	8 (9.2)/79 (90.8)	7 (8.64)/74 (91.36)	0.000	1.000
Renal failure (Yes/No)	8 (9.2)/79 (90.8)	16 (19.75)/65 (80.25)	3.005	0.083
Pneumonia (Yes/No)	6 (6.9)/81 (93.1)	12 (14.81)/69 (85.19)	1.984	0.159
Septicemia (Yes/No)	14 (16.09)/73 (83.91)	14 (17.28)/67 (82.72)	0.000	1.000
NSAID use (Yes/No)	43 (49.43)/44 (50.57)	50 (61.73%)/31 (38.27)	2.095	0.148
Anticoagulant use (Yes/No)	29 (33.33)/58 (66.67)	37 (45.68)/44 (54.32)	2.188	0.139

M: Male; F: Female; BMI: Body mass index; NSAID: Nonsteroidal anti-inflammatory drug.

Table 2 Laboratory parameters, n (%)

Parameter	Without rebleeding group (n = 87)	Rebleeding group (n = 81)	t value	P value
Hemoglobin (g/L)	113.95 ± 11.44	109.14 ± 10.48	2.843	0.005
Platelet count (× 104/microliter)	24.48 ± 8.15	22.97 ± 6.37	1.344	0.181
INR	1.34 ± 0.18	1.48 ± 0.29	3.710	< 0.001
Albumin (g/dL)	3.91 ± 0.59	3.79 ± 0.67	1.168	0.244

INR: International normalized ratio.

Table 3 Endoscopic findings, n (%)

Parameter	Without rebleeding group (n = 87)	Rebleeding group (n = 81)	t/χ2	P value
Active bleeding (Yes/No)	37 (42.53)/50 (57.47)	53 (65.43)/28 (34.57)	7.950	0.005
Average ulcer size (cm)	1.19 ± 0.58	1.8 ± 0.65	6.348	< 0.001
Number of ulcers (≤ 2/> 2)	49 (56.32)/38 (43.68)	30 (37.04)/51 (62.96)	5.512	0.019
Ulcer location (gastric/duodenal)	35 (40.23)/52 (59.77)	38 (46.91)/43 (53.09)	0.515	0.473

Table 4 Treatment and management, n (%)

Parameter	Without rebleeding group (n = 87)	Rebleeding group (n = 81)	χ2	P value
PPI therapy (Yes/No)	85 (97.7)/2 (2.3)	77 (95.06)/4 (4.94)	0.255	0.613
Endoscopic therapy (Yes/No)	60 (68.97)/27 (31.03)	30 (37.04)/51 (62.96)	15.933	< 0.001
Blood transfusion (Yes/No)	39 (44.83)/48 (55.17)	53 (65.43)/28 (34.57)	6.381	0.012

PPI: Proton pump inhibitor.

Table 5 Spearman correlation analysis

	r value	R2 value	P value
Rockall score	0.735	0.541	< 0.001
Hemoglobin (g/L)	-0.215	0.046	0.005
INR	0.281	0.079	< 0.001
Average ulcer size (cm)	0.443	0.197	< 0.001
Renal failure (Yes/No)	0.151	0.023	0.051
Active bleeding (Yes/No)	0.229	0.053	0.003
Number of ulcers (≤ 2/>2)	-0.193	0.037	0.012
Endoscopic therapy (Yes/No)	-0.32	0.102	< 0.001
Blood transfusion (Yes/No)	0.207	0.043	0.007

INR: International normalized ratio.

Table 6 Receiver operating characteristic analysis

	Sensitivities	Specificities	AUC	Youden index
Rockall score	0.914	0.816	0.933	0.730
Hemoglobin (g/L)	0.519	0.736	0.641	0.255
INR	0.494	0.874	0.668	0.368
Average ulcer size (cm)	0.864	0.552	0.752	0.416
Active bleeding (Yes/No)	0.654	0.575	0.615	0.229
Number of ulcers (≤ 2/>2)	0.63	0.563	0.596	0.193
Endoscopic therapy (Yes/No)	0.63	0.69	0.66	0.32
Blood transfusion (Yes/No)	0.654	0.552	0.603	0.206

INR: International normalized ratio; AUC: Area under the curve.

Table 7 Logistic regression

Factor	Univariate regression				Multivariate regression
	OR	95%CI	β	P value	OR	95%CI	β	P value
Rockall score	3.891	2.729-6.057	1.359	< 0.001	1.134	1.106-1.164	0.126	0
Hemoglobin (g/L)	0.96	0.932-0.988	-0.04	0.007	0.998	0.994-1.002	-0.002	0.317
INR	11.647	3.092-48.723	2.455	< 0.001	1.142	0.926-1.409	0.133	0.214
Average ulcer size (cm)	5.013	2.826-9.577	1.612	< 0.001	1.156	1.069-1.25	0.145	0
Active bleeding (Yes/No)	2.558	1.378-4.822	0.939	0.003	1.117	1.007-1.24	0.111	0.036
Number of ulcers (≤ 2/>2)	0.456	0.244-0.843	-0.785	0.013	0.91	0.824-1.006	-0.094	0.065
Endoscopic therapy (Yes/No)	0.265	0.138-0.497	-1.329	< 0.001	0.908	0.817-1.01	-0.096	0.075
Blood transfusion (Yes/No)	2.33	1.257-4.382	0.846	0.008	1.055	0.955-1.166	0.054	0.29

INR: International normalized ratio; OR: Odds ratio; CI: Confidence interval.