Prediction of in-hospital mortality after acute upper gastrointestinal bleeding: cross-validation of several risk scoring systems
Objective We aimed to identify the clinical, biochemical, and endoscopic features associated with in-hospital mortality after acute upper gastrointestinal bleeding (AUGIB), focusing on cross-validation of the Glasgow-Blatchford score (GBS), full Rockall score (RS), and Cedars-Sinai Medical Center Pr...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-03-01
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| Series: | Journal of International Medical Research |
| Online Access: | https://doi.org/10.1177/03000605221086442 |
| _version_ | 1818157128562507776 |
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| author | Daniela Benedeto-Stojanov Milica Bjelaković Dragan Stojanov Boris Aleksovski |
| author_facet | Daniela Benedeto-Stojanov Milica Bjelaković Dragan Stojanov Boris Aleksovski |
| author_sort | Daniela Benedeto-Stojanov |
| collection | DOAJ |
| description | Objective We aimed to identify the clinical, biochemical, and endoscopic features associated with in-hospital mortality after acute upper gastrointestinal bleeding (AUGIB), focusing on cross-validation of the Glasgow-Blatchford score (GBS), full Rockall score (RS), and Cedars-Sinai Medical Center Predictive Index (CSMCPI) scoring systems. Methods Our prospective cross-sectional study included 156 patients with AUGIB. Several statistical approaches were used to assess the predictive accuracy of the scoring systems. Results All three scoring systems were able to accurately predict in-hospital mortality (area under the receiver operating characteristic curve [AUC] > 0.9); however, the multiple logistic model separated the presence of hemodynamic instability (state of shock) and the CSMCPI as the only significant predictive risk factors. In compliance with the overall results, the CSMCPI was consistently found to be superior to the other two systems (highest AUC, highest sensitivity and specificity, highest positive and negative predictive values, highest positive likelihood ratio, lowest negative likelihood ratio, and 1-unit increase in CSMCPI associated with 6.3 times higher odds of mortality), outperforming the GBS and full RS. Conclusions We suggest consideration of the CSMCPI as a readily available and reliable tool for accurately predicting in-hospital mortality after AUGIB, thus providing an essential backbone in clinical decision-making. |
| first_indexed | 2024-12-11T15:09:16Z |
| format | Article |
| id | doaj.art-9d1fe2c9e0c046b1a3eb5fc32870b2fa |
| institution | Directory Open Access Journal |
| issn | 1473-2300 |
| language | English |
| last_indexed | 2024-12-11T15:09:16Z |
| publishDate | 2022-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of International Medical Research |
| spelling | doaj.art-9d1fe2c9e0c046b1a3eb5fc32870b2fa2022-12-22T01:00:48ZengSAGE PublishingJournal of International Medical Research1473-23002022-03-015010.1177/03000605221086442Prediction of in-hospital mortality after acute upper gastrointestinal bleeding: cross-validation of several risk scoring systemsDaniela Benedeto-StojanovMilica BjelakovićDragan StojanovBoris AleksovskiObjective We aimed to identify the clinical, biochemical, and endoscopic features associated with in-hospital mortality after acute upper gastrointestinal bleeding (AUGIB), focusing on cross-validation of the Glasgow-Blatchford score (GBS), full Rockall score (RS), and Cedars-Sinai Medical Center Predictive Index (CSMCPI) scoring systems. Methods Our prospective cross-sectional study included 156 patients with AUGIB. Several statistical approaches were used to assess the predictive accuracy of the scoring systems. Results All three scoring systems were able to accurately predict in-hospital mortality (area under the receiver operating characteristic curve [AUC] > 0.9); however, the multiple logistic model separated the presence of hemodynamic instability (state of shock) and the CSMCPI as the only significant predictive risk factors. In compliance with the overall results, the CSMCPI was consistently found to be superior to the other two systems (highest AUC, highest sensitivity and specificity, highest positive and negative predictive values, highest positive likelihood ratio, lowest negative likelihood ratio, and 1-unit increase in CSMCPI associated with 6.3 times higher odds of mortality), outperforming the GBS and full RS. Conclusions We suggest consideration of the CSMCPI as a readily available and reliable tool for accurately predicting in-hospital mortality after AUGIB, thus providing an essential backbone in clinical decision-making.https://doi.org/10.1177/03000605221086442 |
| spellingShingle | Daniela Benedeto-Stojanov Milica Bjelaković Dragan Stojanov Boris Aleksovski Prediction of in-hospital mortality after acute upper gastrointestinal bleeding: cross-validation of several risk scoring systems Journal of International Medical Research |
| title | Prediction of in-hospital mortality after acute upper gastrointestinal bleeding: cross-validation of several risk scoring systems |
| title_full | Prediction of in-hospital mortality after acute upper gastrointestinal bleeding: cross-validation of several risk scoring systems |
| title_fullStr | Prediction of in-hospital mortality after acute upper gastrointestinal bleeding: cross-validation of several risk scoring systems |
| title_full_unstemmed | Prediction of in-hospital mortality after acute upper gastrointestinal bleeding: cross-validation of several risk scoring systems |
| title_short | Prediction of in-hospital mortality after acute upper gastrointestinal bleeding: cross-validation of several risk scoring systems |
| title_sort | prediction of in hospital mortality after acute upper gastrointestinal bleeding cross validation of several risk scoring systems |
| url | https://doi.org/10.1177/03000605221086442 |
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