Comparison of Risk Scores for Predicting Adverse Outcomes in Acute Lower Gastrointestinal Bleeding

IF 2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Gastroenterology Research and Practice Pub Date : 2024-03-21 DOI:10.1155/2024/3111414
Chenyang Li, Enqiang Linghu, Chao Chen
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Abstract

Purpose. Acute lower gastrointestinal bleeding (ALGIB) is a common emergency in gastroenterology. Currently, there is insufficient information to predict adverse outcomes in patients with acute lower gastrointestinal bleeding. Our study is aimed at comparing the effectiveness of the clinical risk scores currently utilized and their ability to predict significant outcomes in lower gastrointestinal bleeding. Methods. We conducted a retrospective observational study of patients who were admitted to ALGIB and underwent colonoscopy or angiography at a single center between January 2018 and December 2022. Adverse outcomes associated with ALGIB included rebleeding, blood transfusion, hemostatic interventions, and in-hospital death. We calculated six risk scores at admission (Oakland, Birmingham, SHA2PE, Ramaekers, SALGIB, and CNUH-5). We measured the accuracy of these scores using the area under the receiver operating characteristic curve (AUC) and compared them with DeLong’s test. Results. 123 patients with confirmed LGIB (aged 65 years, 55-75) were finally included. The most common diagnoses were colorectal cancer (25%) and hemorrhoids (14%). All scores demonstrated sufficient and comparable effectiveness for hemostatic intervention but no discrimination for rebleeding. The Oakland and SALGIB scores were superior to the other scores in predicting blood transfusion (AUC: 0.97 and 0.95, respectively; ) and any adverse outcomes (AUC: 0.78 and 0.78, respectively; ). Conclusions. The Oakland and SALGIB scores outperform the other scores in predicting the requirement for blood transfusion in ALGIB patients, but no single prediction tool had the best ability across all outcomes. Novel risk stratification scores with higher performance are needed for better risk stratification in ALGIB.
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预测急性下消化道出血不良后果的风险评分比较
目的。急性下消化道出血(ALGIB)是消化内科常见的急症。目前,预测急性下消化道出血患者不良后果的信息不足。我们的研究旨在比较目前使用的临床风险评分的有效性及其预测下消化道出血重大后果的能力。研究方法我们对 2018 年 1 月至 2022 年 12 月期间因 ALGIB 入院并在一个中心接受结肠镜检查或血管造影术的患者进行了一项回顾性观察研究。与ALGIB相关的不良后果包括再出血、输血、止血干预和院内死亡。我们计算了入院时的六个风险评分(奥克兰、伯明翰、SHA2PE、Ramaekers、SALGIB 和 CNUH-5)。我们用接收者操作特征曲线下面积(AUC)来衡量这些评分的准确性,并与 DeLong 检验进行比较。结果最终纳入了 123 名确诊为 LGIB 的患者(65 岁,55-75 岁)。最常见的诊断是结肠直肠癌(25%)和痔疮(14%)。所有评分均显示止血干预具有足够且可比的有效性,但对再出血没有区分。奥克兰和 SALGIB 评分在预测输血(AUC 分别为 0.97 和 0.95;)和任何不良后果(AUC 分别为 0.78 和 0.78;)方面优于其他评分。结论Oakland和SALGIB评分在预测ALGIB患者输血需求方面优于其他评分,但没有一种预测工具在所有结果方面具有最佳能力。为了更好地对 ALGIB 进行风险分层,需要性能更高的新型风险分层评分。
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来源期刊
Gastroenterology Research and Practice
Gastroenterology Research and Practice GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.40
自引率
0.00%
发文量
91
审稿时长
1 months
期刊介绍: Gastroenterology Research and Practice is a peer-reviewed, Open Access journal which publishes original research articles, review articles and clinical studies based on all areas of gastroenterology, hepatology, pancreas and biliary, and related cancers. The journal welcomes submissions on the physiology, pathophysiology, etiology, diagnosis and therapy of gastrointestinal diseases. The aim of the journal is to provide cutting edge research related to the field of gastroenterology, as well as digestive diseases and disorders. Topics of interest include: Management of pancreatic diseases Third space endoscopy Endoscopic resection Therapeutic endoscopy Therapeutic endosonography.
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