Title: Which scoring systems are useful for predicting the prognosis of lower gastrointestinal
bleeding? Old and New
Version: 2 Date: 07 Dec 2024
Reviewer:  Ali S. Taha
Reviewer's report:
Ku Bean Jeong et al. Which scoring systems are useful for predicting the prognosis of lower
gastrointestinal bleeding? Old and New.
The authors aimed to evaluate the predictive accuracy of various scoring systems for 30-day
mortality and prolonged hospital stay (#10 days) by analyzing the areas under the receiver-
operating characteristic curves, taking into account factors such as patient age, laboratory
findings, and comorbidities (ABC); AIMS 65; Glasgow-Blatchford; Oakland; Rockall(pre-
endoscopy); SHA2PE; and CHAMPS scores.
They found that “In terms of forecasting 30-day mortality, the AIMS 65, CHAMPS, and
ABC scoring systems demonstrated superior performance (p<0.001). For predicting prolonged
hospital stay, the SHA2PE score exhibited the highest accuracy among all evaluated systems
(p<0.001).
My comments are as follows:
The Blatchford score, Rockall score, and AIMS were specifically designed to assess UPPER GI
bleeding (UGIB). They are known world-wide purely for this condition. To apply them to LGIB
would cause confusion to non-Gastro specialists in Emergency Departments where patients with
bleeding present before being seen by the Gastroenterologists.
The other scoring systems focus on comorbid conditions (best assessed by the established
Charlson score) and the functional status of the patient. These can be very difficult and time
consuming to assess in a busy Emergency Department.
The exception to these is the SHA2PE score that assesses Systolic pressure, Hemoglobin value,
Antiplatelet therapy, Anticoagulant therapy, Pulse, and Emergency room bleeding. This has
been designed for and validated in LGIB.
I believe that these factors impact the practicality and the novelty of the current work by Dr
Jeong and colleagues
Title: Which scoring systems are useful for predicting the prognosis of lower gastrointestinal
bleeding? Old and New
Version: 2 Date: 07 Dec 2024
Reviewer:  Ali S. Taha
Reviewer's report:
Ku Bean Jeong et al. Which scoring systems are useful for predicting the prognosis of lower
gastrointestinal bleeding? Old and New.
The authors aimed to evaluate the predictive accuracy of various scoring systems for 30-day
mortality and prolonged hospital stay (#10 days) by analyzing the areas under the receiver-
operating characteristic curves, taking into account factors such as patient age, laboratory
findings, and comorbidities (ABC); AIMS 65; Glasgow-Blatchford; Oakland; Rockall(pre-
endoscopy); SHA2PE; and CHAMPS scores.
They found that “In terms of forecasting 30-day mortality, the AIMS 65, CHAMPS, and
ABC scoring systems demonstrated superior performance (p<0.001). For predicting prolonged
hospital stay, the SHA2PE score exhibited the highest accuracy among all evaluated systems
(p<0.001).
My comments are as follows:
The Blatchford score, Rockall score, and AIMS were specifically designed to assess UPPER GI
bleeding (UGIB). They are known world-wide purely for this condition. To apply them to LGIB
would cause confusion to non-Gastro specialists in Emergency Departments where patients with
bleeding present before being seen by the Gastroenterologists.
The other scoring systems focus on comorbid conditions (best assessed by the established
Charlson score) and the functional status of the patient. These can be very difficult and time
consuming to assess in a busy Emergency Department.
The exception to these is the SHA2PE score that assesses Systolic pressure, Hemoglobin value,
Antiplatelet therapy, Anticoagulant therapy, Pulse, and Emergency room bleeding. This has
been designed for and validated in LGIB.
I believe that these factors impact the practicality and the novelty of the current work by Dr
Jeong and colleagues
Please review this paper.
user
Title: Which scoring systems are useful for predicting the prognosis of lower gastrointestinal
bleeding? Old and New
Version: 2 Date: 07 Dec 2024
Reviewer:  Ali S. Taha
Reviewer's report:
Ku Bean Jeong et al. Which scoring systems are useful for predicting the prognosis of lower
gastrointestinal bleeding? Old and New.
The authors aimed to evaluate the predictive accuracy of various scoring systems for 30-day
mortality and prolonged hospital stay (#10 days) by analyzing the areas under the receiver-
operating characteristic curves, taking into account factors such as patient age, laboratory
findings, and comorbidities (ABC); AIMS 65; Glasgow-Blatchford; Oakland; Rockall(pre-
endoscopy); SHA2PE; and CHAMPS scores.
They found that “In terms of forecasting 30-day mortality, the AIMS 65, CHAMPS, and
ABC scoring systems demonstrated superior performance (p<0.001). For predicting prolonged
hospital stay, the SHA2PE score exhibited the highest accuracy among all evaluated systems
(p<0.001).
My comments are as follows:
The Blatchford score, Rockall score, and AIMS were specifically designed to assess UPPER GI
bleeding (UGIB). They are known world-wide purely for this condition. To apply them to LGIB
would cause confusion to non-Gastro specialists in Emergency Departments where patients with
bleeding present before being seen by the Gastroenterologists.
The other scoring systems focus on comorbid conditions (best assessed by the established
Charlson score) and the functional status of the patient. These can be very difficult and time
consuming to assess in a busy Emergency Department.
The exception to these is the SHA2PE score that assesses Systolic pressure, Hemoglobin value,
Antiplatelet therapy, Anticoagulant therapy, Pulse, and Emergency room bleeding. This has
been designed for and validated in LGIB.
I believe that these factors impact the practicality and the novelty of the current work by Dr
Jeong and colleagues
assistant