The Progetto Nazionale Emorragia Digestiva (PNED) system vs. the Rockall score as mortality predictors in patients with nonvariceal upper gastrointestinal bleeding: A multicenter prospective study

Background: The predictive scale for mortality risk in patients with nonvariceal upper gastrointestinal bleeding (NVUGIB) proposed by Italy's PNED (Progetto Nazionale Emorragia Digestiva) group has not been validated in Latin America since its original publication. Aim: To compare the PNED syst...

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Main Authors: R. Contreras-Omaña, J.A. Alfaro-Reynoso, C.E. Cruz-Chávez, A. Velarde-Ruiz Velasco, D.I. Flores-Ramírez, I. Romero-Hernández, I. Donato-Olguín, X. García-Samper, A. Bautista-Santos, M. Reyes-Bastidas, E. Millán-Marín
Format: Article
Language:English
Published: Elsevier 2017-04-01
Series:Revista de Gastroenterología de México (English Edition)
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2255534X17300105
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author R. Contreras-Omaña
J.A. Alfaro-Reynoso
C.E. Cruz-Chávez
A. Velarde-Ruiz Velasco
D.I. Flores-Ramírez
I. Romero-Hernández
I. Donato-Olguín
X. García-Samper
A. Bautista-Santos
M. Reyes-Bastidas
E. Millán-Marín
author_facet R. Contreras-Omaña
J.A. Alfaro-Reynoso
C.E. Cruz-Chávez
A. Velarde-Ruiz Velasco
D.I. Flores-Ramírez
I. Romero-Hernández
I. Donato-Olguín
X. García-Samper
A. Bautista-Santos
M. Reyes-Bastidas
E. Millán-Marín
author_sort R. Contreras-Omaña
collection DOAJ
description Background: The predictive scale for mortality risk in patients with nonvariceal upper gastrointestinal bleeding (NVUGIB) proposed by Italy's PNED (Progetto Nazionale Emorragia Digestiva) group has not been validated in Latin America since its original publication. Aim: To compare the PNED system and the Rockall score as mortality predictors in patients hospitalized for NVUGIB. Material and methods: A multicenter, prospective, cross-sectional, analytic study was conducted that recruited patients diagnosed with nonvariceal upper gastrointestinal bleeding within the time frame of 2011 to 2015. Six Mexican hospital centers participated in the study. The Rockall and PNED system scores were calculated, classifying the patients as having mild, moderate, or severe disease. The association between mortality and risk was determined through the chi-square test and relative risk (RR) calculation. Statistical significance was set at a P<.05. Results: Information on 198 patients was collected. Only 8 patients (4%) died from causes directly associated with bleeding. According to the Rockall score, 46 patients had severe disease (23.2%), 5 of whom died, with a RR of 5.5 (CI 1.35-22.02, P=.006). In relation to the PNED, only 8 patients had severe disease (4%), 5 of whom died, with a RR of 38.7 (CI 11.4-137.3, P=.001). Conclusions: The PNED system was more selective for classifying a case as severe, but it had a greater predictive capacity for mortality, compared with the Rockall score.
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spelling doaj.art-3aad65902505491da4a47cd88165349e2022-12-21T20:28:44ZengElsevierRevista de Gastroenterología de México (English Edition)2255-534X2017-04-0182212312810.1016/j.rgmxen.2017.03.001The Progetto Nazionale Emorragia Digestiva (PNED) system vs. the Rockall score as mortality predictors in patients with nonvariceal upper gastrointestinal bleeding: A multicenter prospective studyR. Contreras-Omaña0J.A. Alfaro-Reynoso1C.E. Cruz-Chávez2A. Velarde-Ruiz Velasco3D.I. Flores-Ramírez4I. Romero-Hernández5I. Donato-Olguín6X. García-Samper7A. Bautista-Santos8M. Reyes-Bastidas9E. Millán-Marín10Centro de Investigación de enfermedades hepáticas y Gastrointestinales, Área de Hepatología, Pachuca de Soto, Hidalgo, MexicoUniversidad Autónoma del Estado de Hidalgo, Instituto de Ciencias de la Salud, Área Académica de Medicina, Pachuca de Soto, Hidalgo, MexicoHospital General de Zona y Medicina Familiar N.° 1 IMSS, Pachuca de Soto, Hidalgo, MexicoHospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, MexicoUniversidad Autónoma del Estado de Hidalgo, Instituto de Ciencias de la Salud, Área Académica de Medicina, Pachuca de Soto, Hidalgo, MexicoUniversidad Autónoma del Estado de Hidalgo, Instituto de Ciencias de la Salud, Área Académica de Medicina, Pachuca de Soto, Hidalgo, MexicoUniversidad Autónoma del Estado de Hidalgo, Instituto de Ciencias de la Salud, Área Académica de Medicina, Pachuca de Soto, Hidalgo, MexicoHospital Regional Lic. Adolfo López Mateos ISSSTE, Mexico City, MexicoCentro Médico Nacional Siglo XXI, Mexico City, MexicoHospital Regional N.° 1 IMSS, Culiacán, Sinaloa, MexicoHospital Regional 220 del IMSS, Toluca, Estado de México, MéxicoBackground: The predictive scale for mortality risk in patients with nonvariceal upper gastrointestinal bleeding (NVUGIB) proposed by Italy's PNED (Progetto Nazionale Emorragia Digestiva) group has not been validated in Latin America since its original publication. Aim: To compare the PNED system and the Rockall score as mortality predictors in patients hospitalized for NVUGIB. Material and methods: A multicenter, prospective, cross-sectional, analytic study was conducted that recruited patients diagnosed with nonvariceal upper gastrointestinal bleeding within the time frame of 2011 to 2015. Six Mexican hospital centers participated in the study. The Rockall and PNED system scores were calculated, classifying the patients as having mild, moderate, or severe disease. The association between mortality and risk was determined through the chi-square test and relative risk (RR) calculation. Statistical significance was set at a P<.05. Results: Information on 198 patients was collected. Only 8 patients (4%) died from causes directly associated with bleeding. According to the Rockall score, 46 patients had severe disease (23.2%), 5 of whom died, with a RR of 5.5 (CI 1.35-22.02, P=.006). In relation to the PNED, only 8 patients had severe disease (4%), 5 of whom died, with a RR of 38.7 (CI 11.4-137.3, P=.001). Conclusions: The PNED system was more selective for classifying a case as severe, but it had a greater predictive capacity for mortality, compared with the Rockall score.http://www.sciencedirect.com/science/article/pii/S2255534X17300105Nonvariceal upper gastrointestinal bleedingMortalityRockallProgetto Nazionale Emorragia DigestivaIntensive therapeutic endoscopy
spellingShingle R. Contreras-Omaña
J.A. Alfaro-Reynoso
C.E. Cruz-Chávez
A. Velarde-Ruiz Velasco
D.I. Flores-Ramírez
I. Romero-Hernández
I. Donato-Olguín
X. García-Samper
A. Bautista-Santos
M. Reyes-Bastidas
E. Millán-Marín
The Progetto Nazionale Emorragia Digestiva (PNED) system vs. the Rockall score as mortality predictors in patients with nonvariceal upper gastrointestinal bleeding: A multicenter prospective study
Revista de Gastroenterología de México (English Edition)
Nonvariceal upper gastrointestinal bleeding
Mortality
Rockall
Progetto Nazionale Emorragia Digestiva
Intensive therapeutic endoscopy
title The Progetto Nazionale Emorragia Digestiva (PNED) system vs. the Rockall score as mortality predictors in patients with nonvariceal upper gastrointestinal bleeding: A multicenter prospective study
title_full The Progetto Nazionale Emorragia Digestiva (PNED) system vs. the Rockall score as mortality predictors in patients with nonvariceal upper gastrointestinal bleeding: A multicenter prospective study
title_fullStr The Progetto Nazionale Emorragia Digestiva (PNED) system vs. the Rockall score as mortality predictors in patients with nonvariceal upper gastrointestinal bleeding: A multicenter prospective study
title_full_unstemmed The Progetto Nazionale Emorragia Digestiva (PNED) system vs. the Rockall score as mortality predictors in patients with nonvariceal upper gastrointestinal bleeding: A multicenter prospective study
title_short The Progetto Nazionale Emorragia Digestiva (PNED) system vs. the Rockall score as mortality predictors in patients with nonvariceal upper gastrointestinal bleeding: A multicenter prospective study
title_sort progetto nazionale emorragia digestiva pned system vs the rockall score as mortality predictors in patients with nonvariceal upper gastrointestinal bleeding a multicenter prospective study
topic Nonvariceal upper gastrointestinal bleeding
Mortality
Rockall
Progetto Nazionale Emorragia Digestiva
Intensive therapeutic endoscopy
url http://www.sciencedirect.com/science/article/pii/S2255534X17300105
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