Diagnostic Accuracy of Aetiology Score for Predicting Variceal Bleed in Patients of Upper Gastrointestinal Bleeding
Objective: To assess the diagnostic accuracy of aetiology scoring system for diagnosing variceal bleeding in patients presenting with upper gastrointestinal bleeding using endoscopy as gold standard.
Material and Methods: This cross sectional study was conducted at Department of Medicine Unit, Jinnah hospital Lahore (JHL) from 19th December 2015 to 20th May 2016. In total 230 subjects, fulfilling the inclusion criteria were selected by non-probability consecutive sampling technique and informed consent were obtained. Patients were evaluated for variceal bleeding on the basis of aetiology scoring system and then confirmed with endoscopy. Data was analyzed by using SPSS 21.0 and sensitivity, specificity, positive and negative predictive value of aetiology score was calculated taking endoscopy as gold standard.
Results: Out of 230 patients presenting with upper gastrointestinal bleeding, males and females were 48.3% and 51.7% respectively. The mean age was 41.64 + 10.53 years, the mean Upper gastrointestinal bleeding Ateiology score system was 3.23+ 1.55. The sensitivity, specificity, positive predicted value and negative predicted value at a cutoff value of etiological score > 3.1 for variceal bleeding were 90.70%, 82.18%, 86.67% and 87.37% respectively. it was observed that there was statistically significant association between etiological score > 3.1 and endoscopy.
Conclusion: The UGIB Aetiology Score, composed of 3 parameters, using a cut-off ≥ 3.1 accurately predicted variceal bleeding and may help to guide the choice of initial therapy for UGIB before endoscopy.
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