GLASGOW-BLATCHFORD AND ROCKALL SCORE UTILITY IN PREDICTING FINDINGS ON VIDEO CAPSULE ENDOSCOPY IN PATIENTS ADMITTED WITH OVERT SMALL BOWEL BLEEDING

Abstract

Background and Aims Glasgow-Blachford (GBS) and Rockall scores are recognised tools to prioritize patients with upper gastrointestinal bleeding. Its utility in predicting findings on capsule endoscopy (CE) in patients with overt small bowel bleeding (OSBB) remains unclear. The aim was to assess the use of these scores in predicting relevant findings on CE and outcome among patients with suspected OSBB. Methods Retrospective analysis from January 2019 to June 2022. Clinical parameters and scores were collected at presentation and at 24 hours. Univariate analysis used simple logistic regression, chi-squared test or Mann-Whitney as needed. ROC analysis was performed selecting the optimal cut-off point maximized by the Youden index. Results 79 patients were included. 62% had relevant findings. The predictor showing the highest discrimination ability was the Initial GBS (AUC 0.625 95%CI 0.49 – 0.76). The optimal cut-off point was at least 4, with a sensitivity 98%, specificity 30% and accuracy 72%. Multivariable regression analysis showed inpatient status on CE (OR 117.27; CI 11.32 – 4492.93; p=0.001), shorter time to CE (OR 1.02; CI 1.01 – 1.04 p=0.018), higher initial GBS (OR 1.22; CI 1.06 – 1.43 p=0.009) and higher GBS within 24 hours (OR 1.19; CI 1.04 – 1.37 p= 0.013) were predictive factors for relevant findings on CE, with a model AUC 0.802, Sensitivity 91.8% and Specificity 63.3%. Conclusions GBS and Rockall score were useful in predicting relevant findings on CE in this cohort of patients with suspected OSBB. In patients with GBS 5 or higher, an early CE during the same admission, is warranted.