A New Scoring System to Predict Poor Clinical Outcomes in Acute Nonvariceal Upper Gastrointestinal Bleeding Patients with High-Risk Stigmata
Aims. To explore the risk factors for rebleeding in acute nonvariceal upper gastrointestinal bleeding patients with high-risk stigmata after endoscopic hemostasis and to develop a new scoring system for them. Methods. A retrospective single-center study was conducted from January 2012 to June 2017....
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2018/5032657 |
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| author | Zhiyu Dong Junwen Wang Tingting Zhan Haiqin Zhang Lisha Yi Shuchang Xu |
| author_facet | Zhiyu Dong Junwen Wang Tingting Zhan Haiqin Zhang Lisha Yi Shuchang Xu |
| author_sort | Zhiyu Dong |
| collection | DOAJ |
| description | Aims. To explore the risk factors for rebleeding in acute nonvariceal upper gastrointestinal bleeding patients with high-risk stigmata after endoscopic hemostasis and to develop a new scoring system for them. Methods. A retrospective single-center study was conducted from January 2012 to June 2017. The logistic regression model was used to explore risk factors of poor clinical outcomes. Accuracy of new scoring systems was compared with Rockall score (RS) and Glasgow-Blatchford score (GBS) using receiver operating characteristics curve. Results. Two hundred nine patients were included. In multivariate regression analysis, systolic blood pressure, endoscopic hemostasis method, hemoglobin, blood urea nitrogen, and serum creatinine were identified as indicators for rebleeding. New scoring systems with 4 variables and 5 variables based on these 5 risk factors were chosen. The 4-variable scoring system outperformed GBS in predicting rebleeding while 5-variable scoring system outperformed RS and GBS in predicting rebleeding significantly. Score 2 was identified as the best cut-off of these 2 scoring systems. Conclusions. Systolic blood pressure, endoscopic hemostasis method, hemoglobin, blood urea nitrogen, and serum creatinine were all associated with poor clinical outcomes. The new scoring systems had greater accuracy than RS and GBS in predicting rebleeding. Further external validation should be performed to verify the results. |
| format | Article |
| id | doaj-art-9934ac009de74cac935331d87a215145 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-9934ac009de74cac935331d87a2151452025-08-20T03:37:03ZengWileyGastroenterology Research and Practice1687-61211687-630X2018-01-01201810.1155/2018/50326575032657A New Scoring System to Predict Poor Clinical Outcomes in Acute Nonvariceal Upper Gastrointestinal Bleeding Patients with High-Risk StigmataZhiyu Dong0Junwen Wang1Tingting Zhan2Haiqin Zhang3Lisha Yi4Shuchang Xu5Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai, ChinaAims. To explore the risk factors for rebleeding in acute nonvariceal upper gastrointestinal bleeding patients with high-risk stigmata after endoscopic hemostasis and to develop a new scoring system for them. Methods. A retrospective single-center study was conducted from January 2012 to June 2017. The logistic regression model was used to explore risk factors of poor clinical outcomes. Accuracy of new scoring systems was compared with Rockall score (RS) and Glasgow-Blatchford score (GBS) using receiver operating characteristics curve. Results. Two hundred nine patients were included. In multivariate regression analysis, systolic blood pressure, endoscopic hemostasis method, hemoglobin, blood urea nitrogen, and serum creatinine were identified as indicators for rebleeding. New scoring systems with 4 variables and 5 variables based on these 5 risk factors were chosen. The 4-variable scoring system outperformed GBS in predicting rebleeding while 5-variable scoring system outperformed RS and GBS in predicting rebleeding significantly. Score 2 was identified as the best cut-off of these 2 scoring systems. Conclusions. Systolic blood pressure, endoscopic hemostasis method, hemoglobin, blood urea nitrogen, and serum creatinine were all associated with poor clinical outcomes. The new scoring systems had greater accuracy than RS and GBS in predicting rebleeding. Further external validation should be performed to verify the results.http://dx.doi.org/10.1155/2018/5032657 |
| spellingShingle | Zhiyu Dong Junwen Wang Tingting Zhan Haiqin Zhang Lisha Yi Shuchang Xu A New Scoring System to Predict Poor Clinical Outcomes in Acute Nonvariceal Upper Gastrointestinal Bleeding Patients with High-Risk Stigmata Gastroenterology Research and Practice |
| title | A New Scoring System to Predict Poor Clinical Outcomes in Acute Nonvariceal Upper Gastrointestinal Bleeding Patients with High-Risk Stigmata |
| title_full | A New Scoring System to Predict Poor Clinical Outcomes in Acute Nonvariceal Upper Gastrointestinal Bleeding Patients with High-Risk Stigmata |
| title_fullStr | A New Scoring System to Predict Poor Clinical Outcomes in Acute Nonvariceal Upper Gastrointestinal Bleeding Patients with High-Risk Stigmata |
| title_full_unstemmed | A New Scoring System to Predict Poor Clinical Outcomes in Acute Nonvariceal Upper Gastrointestinal Bleeding Patients with High-Risk Stigmata |
| title_short | A New Scoring System to Predict Poor Clinical Outcomes in Acute Nonvariceal Upper Gastrointestinal Bleeding Patients with High-Risk Stigmata |
| title_sort | new scoring system to predict poor clinical outcomes in acute nonvariceal upper gastrointestinal bleeding patients with high risk stigmata |
| url | http://dx.doi.org/10.1155/2018/5032657 |
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