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Journals / Aydın Sağlık Dergisi / 2026 / Cilt: 12 Sayı: 2

Predictive Value of the CRUSADE Score for Rebleeding and Mortality in Upper Gastrointestinal Bleeding

Üst Gastrointestinal Kanamalarda Yeniden Kanama ve Mortaliteyi Öngörmede CRUSADE Skorunun Değeri

Melih Çalışkan(İzmir Şehir Hastanesi)0009-0001-2235-0605
Abdurrahman Şahin(TOKAT GAZİOSMANPAŞA ÜNİVERSİTESİ)0000-0001-5477-9492
Pages
129–144
Publication Date
2026-06-29
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The Rockall score was most effective for predicting early mortality, the Glasgow-Blatchford score for mid- and long-term mortality, and the CRUSADE score for rebleeding risk.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: Upper gastrointestinal (GI) bleeding is associated with significant morbidity and mortality.
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Key Findings & Data:This study aimed to compare the performance of the Rockall, Glasgow-Blatchford, and CRUSADE scoring systems in predicting mortality and rebleeding in patients with upper GI bleeding.
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Conclusion & Impact:The Rockall score was most effective for predicting early mortality, the Glasgow-Blatchford score for mid- and long-term mortality, and the CRUSADE score for rebleeding risk.
🔬Design:Araştırma Makalesi
📍Scope:2019 Verileri
⚙️Variables:Üst gastrointestinal kanama · CRUSADE skoru · Rockall skoru

Abstract

Objective: Upper gastrointestinal (GI) bleeding is associated with significant morbidity and mortality. This study aimed to compare the performance of the Rockall, Glasgow-Blatchford, and CRUSADE scoring systems in predicting mortality and rebleeding in patients with upper GI bleeding. Materials and Methods: In this retrospective study, 194 patients diagnosed with upper GI bleeding between January 1, 2019, and December 31, 2021 were included. Demographic, clinical, and laboratory data were analyzed. Rockall, Glasgow-Blatchford, and CRUSADE scores were calculated. The predictive performance of the scores for mortality and rebleeding was evaluated using ROC analysis. Results: The mean age was 66.3±17.15 years, and 67.5% of the patients were male. Rebleeding occurred in 30.9% of patients, in-hospital mortality was 8.8%, and 1-year mortality was 23.1%. ROC analysis showed that the Rockall score had the highest AUC for predicting mortality (0.81). The Glasgow-Blatchford score was associated with mortality timing, whereas the CRUSADE score showed a significant association with rebleeding. Conclusion: Rockall, Glasgow-Blatchford, and CRUSADE scores provide valuable prognostic information for different clinical outcomes in patients with upper GI bleeding. The Rockall score was most effective for predicting early mortality, the Glasgow-Blatchford score for mid- and long-term mortality, and the CRUSADE score for rebleeding risk.

Özet

ÖZ Amaç: Üst gastrointestinal sistem (GİS) kanamaları, yüksek morbidite ve mortalite ile ilişkili önemli klinik durumlardır. Bu çalışmada Rockall, Glasgow-Blatchford ve CRUSADE skorlama sistemlerinin, üst GİS kanamalı hastalarda mortalite ve yeniden kanama riskini öngörmedeki performanslarının karşılaştırılması amaçlandı. Gereç ve Yöntem: Bu retrospektif çalışmaya, 01 Ocak 2019–31 Aralık 2021 tarihleri arasında üst GİS kanaması tanısı alan 194 hasta dahil edildi. Hastaların demografik, klinik ve laboratuvar verileri incelendi. Rockall, Glasgow-Blatchford ve CRUSADE skorları hesaplandı. Skorların mortalite ve yeniden kanamayı öngörme performansı ROC analizi ile değerlendirildi. Bulgular: Ortalama yaş 66,3±17,15 yıl olup hastaların %67,5’i erkekti. Yeniden kanama oranı %30,9, hastane içi mortalite %8,8 ve 1 yıllık mortalite %23,1 olarak bulundu. ROC analizinde Rockall skorunun mortaliteyi öngörmede en yüksek AUC değerine sahip olduğu (0,81) görüldü. Glasgow-Blatchford skoru mortalite zamanlaması ile ilişkili bulunurken, CRUSADE skorunun yeniden kanama ile anlamlı ilişkisi saptandı. Sonuç: Rockall, Glasgow-Blatchford ve CRUSADE skorları üst GİS kanamalı hastalarda farklı prognostik sonlanımlar açısından değerli bilgiler sağlamaktadır. Rockall skoru erken mortaliteyi, Glasgow-Blatchford skoru orta ve uzun dönem mortaliteyi, CRUSADE skoru ise yeniden kanama riskini öngörmede klinik olarak anlamlı bulunmuştur.

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Cite This Article

Çalışkan, M., Şahin, A. (2026). Predictive Value of the CRUSADE Score for Rebleeding and Mortality in Upper Gastrointestinal Bleeding. Aydın Sağlık Dergisi, Cilt: 12 Sayı: 2, 129–144. https://ajindex.com/articles/1458574

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References (14)

  1. Barkun, A. N., Almadi, M., Kuipers, E. J., Laine, L., Sung, J., Tse, F., Leontiadis, G. I., Abraham, N. S., Calvet, X., Chan, F. K. L., Douketis, J., Enns, R., Gralnek, I. M., Jairath, V., Jensen, D., Lau, J., Lip, G. Y. H., Loffroy, R., Maluf-Filho, F., … Bardou, M. (2019). Management of nonvariceal upper gastrointestinal bleeding: Guideline recommendations from the International Consensus Group. Annals of Internal Medicine, 171(11), 805–822. https://doi.org/10.7326/M19-1795
  2. Blatchford, O., Murray, W. R., & Blatchford, M. (2000). A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. The Lancet, 356(9238), 1318–1321. https://doi.org/10.1016/S0140-6736(00)02816-6
  3. Boustany, A., Alali, A. A., Almadi, M., Martel, M., & Barkun, A. N. (2023). Preendoscopic scores predicting low-risk patients with upper gastrointestinal bleeding: A systematic review and meta-analysis. Journal of Clinical Medicine, 12(16), 5194. https://doi.org/10.3390/jcm12165194
  4. Franco, M. C., Jang, S., Martins, B. C., Stevens, P. D., Jeon, S. R., Gan, S. I., Pleskow, D. K., & Sethi, A. (2022). Risk stratification in cancer patients with acute upper gastrointestinal bleeding: Comparison of Glasgow-Blatchford, Rockall and AIMS65, and development of a new scoring system. Clinical Endoscopy, 55(2), 240–247. https://doi.org/10.5946/ce.2021.115
  5. Gralnek, I. M., Stanley, A. J., Morris, A. J., Camus, M., Lau, J., Lanas, A., Laine, L., Meltzer, A. C., Chan, F. K. L., Mostafa, F., Vakil, N., Tham, T. C. K., Marmo, R., & Dumonceau, J.-M. (2021). Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) guideline – Update 2021. Endoscopy, 53(3), 300–332. https://doi.org/10.1055/a-1369-5274
  6. Laine, L., Barkun, A. N., Saltzman, J. R., Martel, M., & Leontiadis, G. I. (2021). ACG clinical guideline: Upper gastrointestinal and ulcer bleeding. The American Journal of Gastroenterology, 116(5), 899–917. https://doi. org/10.14309/ajg.0000000000001245
  7. Laursen, S. B., Dalton, H. R., Murray, I. A., Michell, N., Johnston, M. R., Schultz, M., Hansen, J. M., Schaffalitzky de Muckadell, O. B., Blatchford, O., & Stanley, A. J. (2015). Performance of new thresholds of the Glasgow- Blatchford score in managing patients with upper gastrointestinal bleeding. Clinical Gastroenterology and Hepatology, 13(1), 115–121.e2. https://doi. org/10.1016/j.cgh.2014.07.023
  8. Laursen, S. B., Oakland, K., Laine, L., Bieber, V., Marmo, R., Redondo-Cerezo, E., Dalton, H. R., Ngu, J., Schultz, M., Soncini, M., Gralnek, I., Jairath, V., Murray, I. A., & Stanley, A. J. (2021). ABC score: A new risk score that accurately predicts mortality in acute upper and lower gastrointestinal bleeding: An international multicentre study. Gut, 70(4), 707–716. https:// doi.org/10.1136/gutjnl-2019-320002
  9. Marmo, R., Koch, M., Cipolletta, L., Capurso, L., Pera, A., Bianco, M. A., Rocca, R., Dezi, A., Fasoli, R., Brunati, S., Lorenzini, I., Germani, U., Di Matteo, G., Giorgio, P., Imperiali, G., Minoli, G., Barberani, F., Boschetto, S., Martorano, M., … Rotondano, G. (2008). Predictive factors of mortality from nonvariceal upper gastrointestinal hemorrhage: A multicenter study. The American Journal of Gastroenterology, 103(7), 1639–1647. https:// doi.org/10.1111/j.1572-0241.2008.01865.x
  10. Orpen-Palmer, J., & Stanley, A. J. (2022). Update on the management of upper gastrointestinal bleeding. BMJ Medicine, 1(1), e000202. https://doi. org/10.1136/bmjmed-2022-000202
  11. Rockall, T. A., Logan, R. F., Devlin, H. B., & Northfield, T. C. (1996). Risk assessment after acute upper gastrointestinal haemorrhage. Gut, 38(3), 316–321. https://doi.org/10.1136/gut.38.3.316
  12. Stanley, A. J. (2012). Update on risk scoring systems for patients with upper gastrointestinal haemorrhage. World Journal of Gastroenterology, 18(22), 2739–2744. https://doi.org/10.3748/wjg.v18.i22.2739
  13. Stanley, A. J., Laine, L., Dalton, H. R., Ngu, J. H., Schultz, M., Abazi, R., Zakko, L., Thornton, S., Wilkinson, K., Khor, C. J. L., Murray, I. A., & Laursen, S. B. (2017). Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: International multicentre prospective study. BMJ, 356, i6432. https://doi.org/10.1136/bmj.i6432
  14. Subherwal, S., Bach, R. G., Chen, A. Y., Gage, B. F., Rao, S. V., Newby, L. K., Wang, T. Y., Gibler, W. B., Ohman, E. M., Roe, M. T., Pollack, C. V., Jr., Peterson, E. D., & Alexander, K. P. (2009). Baseline risk of major bleeding in non-ST-segment-elevation myocardial infarction: The CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) bleeding score. Circulation, 119(14), 1873–1882. https://doi.org/10.1161/ CIRCULATIONAHA.108.828541