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Early Risk Score for Predicting Hypotension in Normotensive Patients with Non-Variceal Upper Gastrointestinal Bleeding

Risk assessment for upper gastrointestinal bleeding (UGIB) is important; however, current scoring systems are insufficient. We aimed to develop and validate a prediction model for rapidly determining the occurrence of hypotension in non-variceal UGIB patients with normotension (systolic blood pressu...

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Autores principales: Ko, Byuk Sung, Kim, Youn-Jung, Jung, Dae Ho, Sohn, Chang Hwan, Seo, Dong Woo, Lee, Yoon-Seon, Lim, Kyoung Soo, Jung, Hwoon-yong, Kim, Won Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352164/
https://www.ncbi.nlm.nih.gov/pubmed/30609708
http://dx.doi.org/10.3390/jcm8010037
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author Ko, Byuk Sung
Kim, Youn-Jung
Jung, Dae Ho
Sohn, Chang Hwan
Seo, Dong Woo
Lee, Yoon-Seon
Lim, Kyoung Soo
Jung, Hwoon-yong
Kim, Won Young
author_facet Ko, Byuk Sung
Kim, Youn-Jung
Jung, Dae Ho
Sohn, Chang Hwan
Seo, Dong Woo
Lee, Yoon-Seon
Lim, Kyoung Soo
Jung, Hwoon-yong
Kim, Won Young
author_sort Ko, Byuk Sung
collection PubMed
description Risk assessment for upper gastrointestinal bleeding (UGIB) is important; however, current scoring systems are insufficient. We aimed to develop and validate a prediction model for rapidly determining the occurrence of hypotension in non-variceal UGIB patients with normotension (systolic blood pressure ≥90 mmHg) at emergency department presentation. In this prospective observational cohort study, consecutive non-variceal UGIB patients between January 2012 and April 2017 were enrolled. We developed and validated a new prediction model through logistic regression, with the occurrence of hypotension <24 h as the primary outcome. Among 3363 UGIB patients, 1439 non-variceal UGIB patients were included. The risk factors for the occurrence of hypotension were lactate level, blood in nasogastric tube, and systolic blood pressure. The area under the curve (AUC) of the new scoring model (LBS—Lactate, Blood in nasogastric tube, Systolic blood pressure) in the development cohort was 0.74, higher than the value of 0.64 of the Glasgow–Blatchford score for predicting the occurrence of hypotension. The AUC of the LBS score in the validation cohort was 0.83. An LBS score of ≤2 had a negative predictive value of 99.5% and an LBS score of ≥7 had a specificity of 97.5% in the validation cohort. The new LBS score stratifies normotensive patients with non-variceal UGIB at risk for developing hypotension.
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spelling pubmed-63521642019-02-01 Early Risk Score for Predicting Hypotension in Normotensive Patients with Non-Variceal Upper Gastrointestinal Bleeding Ko, Byuk Sung Kim, Youn-Jung Jung, Dae Ho Sohn, Chang Hwan Seo, Dong Woo Lee, Yoon-Seon Lim, Kyoung Soo Jung, Hwoon-yong Kim, Won Young J Clin Med Article Risk assessment for upper gastrointestinal bleeding (UGIB) is important; however, current scoring systems are insufficient. We aimed to develop and validate a prediction model for rapidly determining the occurrence of hypotension in non-variceal UGIB patients with normotension (systolic blood pressure ≥90 mmHg) at emergency department presentation. In this prospective observational cohort study, consecutive non-variceal UGIB patients between January 2012 and April 2017 were enrolled. We developed and validated a new prediction model through logistic regression, with the occurrence of hypotension <24 h as the primary outcome. Among 3363 UGIB patients, 1439 non-variceal UGIB patients were included. The risk factors for the occurrence of hypotension were lactate level, blood in nasogastric tube, and systolic blood pressure. The area under the curve (AUC) of the new scoring model (LBS—Lactate, Blood in nasogastric tube, Systolic blood pressure) in the development cohort was 0.74, higher than the value of 0.64 of the Glasgow–Blatchford score for predicting the occurrence of hypotension. The AUC of the LBS score in the validation cohort was 0.83. An LBS score of ≤2 had a negative predictive value of 99.5% and an LBS score of ≥7 had a specificity of 97.5% in the validation cohort. The new LBS score stratifies normotensive patients with non-variceal UGIB at risk for developing hypotension. MDPI 2019-01-02 /pmc/articles/PMC6352164/ /pubmed/30609708 http://dx.doi.org/10.3390/jcm8010037 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ko, Byuk Sung
Kim, Youn-Jung
Jung, Dae Ho
Sohn, Chang Hwan
Seo, Dong Woo
Lee, Yoon-Seon
Lim, Kyoung Soo
Jung, Hwoon-yong
Kim, Won Young
Early Risk Score for Predicting Hypotension in Normotensive Patients with Non-Variceal Upper Gastrointestinal Bleeding
title Early Risk Score for Predicting Hypotension in Normotensive Patients with Non-Variceal Upper Gastrointestinal Bleeding
title_full Early Risk Score for Predicting Hypotension in Normotensive Patients with Non-Variceal Upper Gastrointestinal Bleeding
title_fullStr Early Risk Score for Predicting Hypotension in Normotensive Patients with Non-Variceal Upper Gastrointestinal Bleeding
title_full_unstemmed Early Risk Score for Predicting Hypotension in Normotensive Patients with Non-Variceal Upper Gastrointestinal Bleeding
title_short Early Risk Score for Predicting Hypotension in Normotensive Patients with Non-Variceal Upper Gastrointestinal Bleeding
title_sort early risk score for predicting hypotension in normotensive patients with non-variceal upper gastrointestinal bleeding
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352164/
https://www.ncbi.nlm.nih.gov/pubmed/30609708
http://dx.doi.org/10.3390/jcm8010037
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