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Effect of graded intervention based on Rockall risk score in patients with acute non-variceal upper gastrointestinal bleeding
Received date: 2025-08-14
Online published: 2026-01-22
Objective To investigate the application effect of graded intervention based on Rockall risk score in patients with acute non-variceal upper gastrointestinal bleeding (ANVUGIB). Methods A total of 218 patients with ANVUGIB admitted to the hospital between January 2021 and January 2025 were selected, and randomly assigned to the study group (n = 110) and the control group (n = 108). The control group received conventional treatment and intervention measures. On this basis, the study group was given graded intervention based on Rockall risk score. Comparisons were made between the two groups on rebleeding rates under different Rockall risk levels, hemoglobin (Hb) levels, platelet count (PLT), clinical symptom improvement time, ANVUGIB self-management scores, Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores, and clinical outcomes. Results After intervention, the rebleeding rates of patients at intermediate Rockall risk and high risk in the study group (12.90% and 17.65%) were lower than those in the control group (28.57% and 53.85%) (P < 0.05). The total rebleeding rate in the study group (10.00%) was lower than that in the control group (25.93%) (P < 0.05). After 1 week and 1 month of intervention, Hb levels and PLT in the study group were higher than those in the control group (P < 0.05). The time to stopping bleeding, hematemesis or melena disappearing, blood pressure returning to normal, and heart rate returning to normal was shorter in the study group than in the control group (P < 0.05). After 1 week and 1 month of intervention, ANVUGIB self-management scores of the study group were higher than those of the control group. The SAS and SDS scores were lower than those of the control group (P < 0.05). The blood transfusion rate and complication rate during hospitalization were comparable between the two groups of patients (P > 0.05). Hospital stay of the study group was shorter than that of the control group (P < 0.05). Conclusion Graded intervention based on Rockall risk score can improve bleeding symptoms, reduce rebleeding rate, enhance self-management ability, alleviate anxiety, and improve clinical outcomes in patients with ANVUGIB.
Lisha WANG , Guiqiong XIE , Xi WANG , Qian LI , Chunxia WANG , Miao TIAN , Hong Dai , Linlin CHEN , Yulan JIA . Effect of graded intervention based on Rockall risk score in patients with acute non-variceal upper gastrointestinal bleeding[J]. The Journal of Practical Medicine, 2026 , 42(2) : 348 -354 . DOI: 10.3969/j.issn.1006-5725.2026.02.022
| [1] | RA?IU I, LUPU?ORU R, POPESCU A, et al. Acute gastrointestinal bleeding: A comparison between variceal and nonvariceal gastrointestinal bleeding[J]. Medicine,2022,101(45):3154-3163. doi: 10.1097/MD.0000000000031543 . |
| [2] | HREINSSON J P, JONSSON A, BJORNSSON E S. Acute upper gastrointestinal bleeding: A population-based, five-year follow-up study[J]. Scand J Gastroenterol,2021,56(1):1-5. doi: 10.1080/00365521.2020.1849384 . |
| [3] | GUO C L T, WONG S H, LAU L H S, et al. Timing of endoscopy for acute upper gastrointestinal bleeding: A territory-wide cohort study[J]. Gut,2022,71(8):1544-1550. doi: 10.1136/gutjnl-2020-323054 . |
| [4] | LEE A Y, CHO J Y. Advancements in hemostatic strategies for managing upper gastrointestinal bleeding: A comprehensive review[J]. World J Gastroenterol,2024,30(15):2087-2090. doi: 10.3748/wjg.v30.i15.2087 . |
| [5] | 秦青,沈翔,王伟,等. 内镜下金属止血夹联合埃索美拉唑治疗ForrestⅡb级急性非静脉曲张性消化道出血的效果及经济效益分析[J]. 实用医学杂志,2023,39(4):456-459. doi: 10.3969/j.issn.1006-5725.2023.04.012 . |
| [6] | RIMONDI A, SORGE A, MURINO A, et al. Treatment options for gastrointestinal bleeding blue rubber bleb nevus syndrome: Systematic review[J]. Dig Endosc,2024,36(2):162-171. doi: 10.1111/den.14564 . |
| [7] | KOZAI L, TAN A, NEBREJAS K, et al. Comparative diagnostic utility of Rockall and Glasgow-Blatchford scores in non-variceal upper gastrointestinal bleeding: A systematic review and meta-analysis[J]. Eur J Gastroenterol Hepatol,2025,37(2):161-166. doi: 10.1097/MEG.0000000000002867 . |
| [8] | FRíAS J S, ARJONA D A, URREGO J A, et al. Validation of the rockall score in upper gastrointestinal tract bleeding in a colombian tertiary hospital[J]. Arq Gastroenterol,2022,59(1):80-88. doi: 10.1590/S0004-2803.202200001-15 . |
| [9] | GRALNEK I M, STANLEY A J, MORRIS A J, et al. Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline-Update 2021[J]. Endoscopy,2021, 53(3):300-332. doi: 10.1055/a-1369-5274 . |
| [10] | CAPELA T L, SILVA V M, FREITAS M, et al. Acute nonvariceal upper gastrointestinal bleeding in patients using anticoagulants: Does the timing of endoscopy affect outcomes[J]. Dig Dis Sci,2024,69(2):570-578. doi: 10.1007/s10620-023-08185-9 . |
| [11] | FRANCO M C, JANG S, MARTINS B D C, et al. Risk stratification in cancer patients with acute upper gastrointestinal bleeding: Comparison of glasgow-blatchford, rockall and aims65, and development of a new scoring system[J]. Clin Endosc,2022,55(2):240-247. doi: 10.5946/ce.2021.115 . |
| [12] | HAN D P, GOU C Q, REN X M. Predictive utility of the Rockall scoring system in patients suffering from acute nonvariceal upper gastrointestinal hemorrhage[J]. World J Gastrointest Surg,2024,16(8):2620-2629. doi: 10.4240/wjgs.v16.i8.2620 . |
| [13] | 农梅香.基于King达标理论风险管理联合专业小组质控模式对消化道出血患者营养状况及自我管理水平的影响[J].中华养生保健,2023,41(24):153-156. |
| [14] | XU Z, ZHANG X, SHI H, et al. Efficacy of acupuncture for anxiety and depression in functional dyspepsia: A systematic review and meta-analysis[J]. PLoS One,2024,19(3):2984-2988. doi: 10.1371/journal.pone.0298438 . |
| [15] | KAVITT R T, GRALNEK I M. Ideal strategy for nonvariceal upper gastrointestinal bleeding[J]. Curr Opin Gastroenterol,2024,40(5):342-347. doi: 10.1097/MOG.0000000000001043 . |
| [16] | BAI L, JIANG W, CHENG R, et al. Does early endoscopy affect the clinical outcomes of patients with acute nonvariceal upper gastrointestinal bleeding? A systematic review and meta-analysis[J]. Gut Liver,2023,17(4):566-580. doi: 10.5009/gnl220291 . |
| [17] | MORARASU B C, SORODOC V, HAISAN A, et al. Age, blood tests and comorbidities and AIMS65 risk scores outperform Glasgow-Blatchford and pre-endoscopic Rockall score in patients with upper gastrointestinal bleeding[J]. World J Clin Cases,2023,11(19):4513-4530. doi: 10.12998/wjcc.v11.i19.4513 . |
| [18] | AKTAS G, USTAOGLU M, BAKIR T, et al. Analysis of the patients with nonvariceal upper gastrointestinal bleeding and comparison of Rockall and Glasgow-Blatchford scores[J]. Indian J Gastroenterol,2022,41(6):576-582. doi: 10.1007/s12664-022-01290-z . |
| [19] | YANG X Z, YU DL, WANG Z, et al. Efficacy and safety of over-the-scope-clips in the therapy of acute nonvariceal upper gastrointestinal bleeding: Meta-analysis[J]. World J Clin Cases,2024,12(21):4680-4690. doi: 10.12998/wjcc.v12.i21.4680 . |
| [20] | ANSHUL, SINGH N, PAHUJA H, et al. The clinical and endoscopic profiles of patients with upper gastrointestinal bleeding (UGIB) and the role of the rockall scoring system in predicting adverse outcomes[J]. Cureus,2023,15(6):4041-4048. doi: 10.7759/cureus.40418 . |
| [21] | MAIA S, FALC?O D, SILVA J, et al. The Clinical impact of rockall and glasgow-blatchford scores in nonvariceal upper gastrointestinal bleeding[J]. GE Port J Gastroenterol,2021, 28(4):243-252. doi: 10.1159/000511809 . |
| [22] | WASSERMAN R D, ABEL W, MONKEMULLER K, et al. Non-variceal upper gastrointestinal bleeding and its endoscopic management[J]. Turk J Gastroenterol,2024,35(8):599-608. doi: 10.5152/tjg.2024.23507 . |
| [23] | WANG X J, SHI Y P, WANG L, et al. Clinical characteristics of acute non-varicose upper gastrointestinal bleeding and the effect of endoscopic hemostasis[J]. World J Clin Cases,2024, 12(9):1597-1605. doi: 10.12998/wjcc.v12.i9.1597 . |
| [24] | TASLIDERE B, SONMEZ E, ?ZCAN A B, et al. Comparison of the quick SOFA score with Glasgow-Blatchford and Rockall scores in predicting severity in patients with upper gastrointestinal bleeding[J]. Am J Emerg Med,2021,7(45):29-36. doi: 10.1016/j.ajem.2021.02.016 . |
| [25] | KILI? M, AK R, DALKILIN? U, et al. Use of the AIMS65 and pre-endoscopy Rockall scores in the prediction of mortality in patients with the upper gastrointestinal bleeding[J]. Ulus Travma Acil Cerrahi Derg,2022,29(1):100-104. doi: 10.14744/tjtes.2022.38890 . |
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