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Novel and Simple Criteria for Predicting Mortality of Peptic Ulcer Disease
OBJECTIVE: Conventional risk scores of peptic ulcer disease (PUD) are based on many parameters, and their application in clinical practice is therefore limited. The aim of this study was to establish simple and reliable criteria for predicting PUD-associated mortality. METHODS: A total of 499 patien...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japanese Society of Internal Medicine
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8381175/ https://www.ncbi.nlm.nih.gov/pubmed/33612689 http://dx.doi.org/10.2169/internalmedicine.6945-20 |
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author | Iwasaki, Hiroyasu Shimura, Takaya Yamada, Tomonori Nishigaki, Ruriko Okuda, Yusuke Fukusada, Shigeki Ozeki, Takanori Kitagawa, Mika Katano, Takahito Tanaka, Mamoru Nishie, Hirotada Ozeki, Keiji Kubota, Eiji Tanida, Satoshi Kataoka, Hiromi |
author_facet | Iwasaki, Hiroyasu Shimura, Takaya Yamada, Tomonori Nishigaki, Ruriko Okuda, Yusuke Fukusada, Shigeki Ozeki, Takanori Kitagawa, Mika Katano, Takahito Tanaka, Mamoru Nishie, Hirotada Ozeki, Keiji Kubota, Eiji Tanida, Satoshi Kataoka, Hiromi |
author_sort | Iwasaki, Hiroyasu |
collection | PubMed |
description | OBJECTIVE: Conventional risk scores of peptic ulcer disease (PUD) are based on many parameters, and their application in clinical practice is therefore limited. The aim of this study was to establish simple and reliable criteria for predicting PUD-associated mortality. METHODS: A total of 499 patients with PUD were divided into 2 groups: the training cohort (n=333) and the validation cohort (n=166). To minimize selection bias due to missing values, we used imputed datasets generated by the multiple imputation method (training-cohort dataset, n=33,300; validation-cohort dataset, n=16,600). RESULTS: In the training-cohort dataset, the heart rate-to-systolic blood pressure ratio (HR/SBP) and serum albumin (s-Alb) level were significant independent predictive factors for mortality according to the multivariate analysis [HR/SBP, odds ratio (OR): 1.72; 95% confidence interval (CI), 1.06-2.80, p=0.028; s-Alb, OR: 0.23, 95% CI, 0.11-0.51, p<0.001]. The model comprising HR/SBP and s-Alb was able to detect mortality due to PUD with an area under the curve (AUC) of 0.855. In the validation-cohort dataset, this model also showed good efficacy with an AUC of 0.835. The novel criteria combining HR/SBP and s-Alb developed by a decision tree analysis showed 73.3% sensitivity and 87.6% specificity for predicting mortality in the total-cohort dataset. Our criteria were superior to the Glasgow Blatchford and Rockall scores and similar to the AIMS65 and Progetto Nazionale Emorragia Digestiva scores for predicting mortality. CONCLUSION: The combination of the HR/SBP ratio and s-Alb level is a good predictor of mortality in patients with PUD. |
format | Online Article Text |
id | pubmed-8381175 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Japanese Society of Internal Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-83811752021-08-30 Novel and Simple Criteria for Predicting Mortality of Peptic Ulcer Disease Iwasaki, Hiroyasu Shimura, Takaya Yamada, Tomonori Nishigaki, Ruriko Okuda, Yusuke Fukusada, Shigeki Ozeki, Takanori Kitagawa, Mika Katano, Takahito Tanaka, Mamoru Nishie, Hirotada Ozeki, Keiji Kubota, Eiji Tanida, Satoshi Kataoka, Hiromi Intern Med Original Article OBJECTIVE: Conventional risk scores of peptic ulcer disease (PUD) are based on many parameters, and their application in clinical practice is therefore limited. The aim of this study was to establish simple and reliable criteria for predicting PUD-associated mortality. METHODS: A total of 499 patients with PUD were divided into 2 groups: the training cohort (n=333) and the validation cohort (n=166). To minimize selection bias due to missing values, we used imputed datasets generated by the multiple imputation method (training-cohort dataset, n=33,300; validation-cohort dataset, n=16,600). RESULTS: In the training-cohort dataset, the heart rate-to-systolic blood pressure ratio (HR/SBP) and serum albumin (s-Alb) level were significant independent predictive factors for mortality according to the multivariate analysis [HR/SBP, odds ratio (OR): 1.72; 95% confidence interval (CI), 1.06-2.80, p=0.028; s-Alb, OR: 0.23, 95% CI, 0.11-0.51, p<0.001]. The model comprising HR/SBP and s-Alb was able to detect mortality due to PUD with an area under the curve (AUC) of 0.855. In the validation-cohort dataset, this model also showed good efficacy with an AUC of 0.835. The novel criteria combining HR/SBP and s-Alb developed by a decision tree analysis showed 73.3% sensitivity and 87.6% specificity for predicting mortality in the total-cohort dataset. Our criteria were superior to the Glasgow Blatchford and Rockall scores and similar to the AIMS65 and Progetto Nazionale Emorragia Digestiva scores for predicting mortality. CONCLUSION: The combination of the HR/SBP ratio and s-Alb level is a good predictor of mortality in patients with PUD. The Japanese Society of Internal Medicine 2021-02-22 2021-08-01 /pmc/articles/PMC8381175/ /pubmed/33612689 http://dx.doi.org/10.2169/internalmedicine.6945-20 Text en Copyright © 2021 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Iwasaki, Hiroyasu Shimura, Takaya Yamada, Tomonori Nishigaki, Ruriko Okuda, Yusuke Fukusada, Shigeki Ozeki, Takanori Kitagawa, Mika Katano, Takahito Tanaka, Mamoru Nishie, Hirotada Ozeki, Keiji Kubota, Eiji Tanida, Satoshi Kataoka, Hiromi Novel and Simple Criteria for Predicting Mortality of Peptic Ulcer Disease |
title | Novel and Simple Criteria for Predicting Mortality of Peptic Ulcer Disease |
title_full | Novel and Simple Criteria for Predicting Mortality of Peptic Ulcer Disease |
title_fullStr | Novel and Simple Criteria for Predicting Mortality of Peptic Ulcer Disease |
title_full_unstemmed | Novel and Simple Criteria for Predicting Mortality of Peptic Ulcer Disease |
title_short | Novel and Simple Criteria for Predicting Mortality of Peptic Ulcer Disease |
title_sort | novel and simple criteria for predicting mortality of peptic ulcer disease |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8381175/ https://www.ncbi.nlm.nih.gov/pubmed/33612689 http://dx.doi.org/10.2169/internalmedicine.6945-20 |
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