Validity Of Rockall Scoring System In Determining In-Hospital Rebleeding Among Cirrhotic Patients With Acute Esophageal/Gastric Variceal Hemorrhage Using Endoscopy As Gold Standard

Maqsood  Ahmad; Naeem  Afzal; Saeed  Akhter; Muhammad  Irfan; Imran  Abdullah; Zahid Yaseen Hashmie

doi:10.29054/apmc/2011.499

Maqsood Ahmad Assistant Professor of Medicine Punjab Medical College, Faisalabad
Naeem Afzal Senior Registrar Medicine Services Hospital Lahore
Saeed Akhter Consultant Physician MMT Hospital Faisalabad
Muhammad Irfan Registrar Allied Hospital Faisalabad
Imran Abdullah SMO PINUM Faisalabad
Zahid Yaseen Hashmie Professor& Head of Medicine Department Punjab Medical College Faisalabad

DOI: https://doi.org/10.29054/apmc/2011.499

Keywords: Esophageal varices, Cirrhosis, Rockall scoring system, Bleeding

Abstract

The rate of rebleeding of esophageal varices remains high after cessation of acute esophageal variceal hemorrhage. Rockall scoring system primarily developed for patients with non variceal source of bleeding. Objective: To determine the validity of Rockall scoring system in determining in-hospital re-bleeding among cirrhotic patients with acute esophageal/gastric variceal haemorrhage using endoscopy as gold standard. The study was conducted in Allied hospital and Liver Centre Allied/DHQ Hospitals, Faisalabad. Study Period: Study was carried out from 28-06-2010 to 27-12-2010. Patients and Methods: Total 176 cases were include in this study. The subjects were scored using Rockall scoring system and placed underobservation for re-bleed in 10 days. Results: The mean age of patients was 50.99±12.47 years. Out of 87 positive cases on Rockall score, 82 cases were true positive. Out of 89 cases, that were negative, 81 were true negative. Sensitivity, Specificity and diagnostic accuracy of Rockall score was found to be 91.1%, 94.1% and 92.6%, respectively. Positive predictive value (PPV) of Rockall score was 94.2% and negative predictive values (NPV) was 90.0%. Conclusion: The risk scoring system developed by Rockall and coworkers is a clinically useful scoring system among cirrhotic patients with acute esophageal/gastric variceal haemorrhage.