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Khirurgii

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Year 2020 Vol. 28 No 2

SCIENTIFIC PUBLICATIONS
GENERAL & SPECIAL SURGE

S.N. POTAKHIN, Y.G. SHAPKIN

COMPARATIVE ANALYSIS OF METHODS FOR PREDICTING OF PEPTIC ULCERS REBLEEDING

Saratov State Medical University, Saratov,
The Russian Federation

Objective. To conduct a comparative analysis of methods for predicting of peptic ulcers rebleeding.
Methods. The research was carried out in 2017-2018 years. In the study, the retrospective analysis of the treatment results of 126 patients with the ulcerative gastrointestinal bleeding and the comparative analysis of nine methods for predicting bleeding recurrence for sensitivity, specificity, accuracy and predictability of a positive result were made. The analysis includes: the classification of J.A. Forrest (1974), the classification of G.P. Giderim (1992) in the author’s modification, Baylor Bleeding score (1993), Rockall score (1996), the method of forecasting by I. I. Zatevakhin et al. (1997), one of the methods of forecasting by M.A. Evseev (2004), the method of M.M. Vinokurov and M.A. Kapitonova (2009), the System for the prediction of bleeding recurrence (Lebedev N.V. et al., 2009), as well as the author’s forecasting methodology for trees classification.
Patients were treated in the surgical department of Saratov City Clinical Hospital ¹ 6 from 2001 to 2009. During this period of time, assistance with this pathology was the most complete and corresponded to all current standards. The analysis included 63 patients with recurrent bleeding and 63 patients without recurrent bleeding.
Results. The optimum ratio of sensitivity and specificity, better accuracy and positive predictive value was revealed for the G.P. Giderim method in our own modification (82.5%; 73%; 78% and 75.4%, respectively) and, somewhat worse, for the author’s forecast method for trees classification (71.2%; 57.1%; 63.9% and 60.9%, respectively).
Conclusions. Classification of J.A. Forrest, traditionally used to assess the risk of recurrence of bleeding, with a high sensitivity (90.5%) has the lowest specificity (20.6%), which significantly reduces the accuracy of the forecast (55.6%). The most effective is the modified classification of G.P. Giderim, which takes into account the characteristic of the ulcerous bottom, the pulse rate, systolic blood pressure and the presence of collapse. Increasing the number of features in other methods does not improve the accuracy of the forecast.

Keywords: bleeding peptic ulcers, predicting of rebleeding, risk assessment, comparative analysis of methods, signs of recurrence high risk
p. 141-149 of the original issue
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Address for correspondence:
410012, Russian Federation,
Saratov, Bolshaya Kazachya Str., 112
Saratov State Medical University,
General Surgery Department.
Tel.: +7 927 220 74 51,
e-mail: potakhin_sn@rambler.ru,
Sergey N. Potakhin
Information about the authors:
Potakhin Sergey N., PhD, Associate Professor, General Surgery Department, Saratov State Medical University, Saratov, Russian Federation.
http://orcid.org/0000-0002-4159-3047
Shapkin Yuri G., MD, Professor, Head of the General Surgery Department, Saratov State Medical University, Saratov, Russian Federation.
http://orcid.org/0000-0003-0186-1892
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