Li Yajie, Lu Qin, Wu Kexuan, Ou Xilong
Department of Gerontology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China.
Department of Gastroenterology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China.
Gastroenterol Res Pract. 2022 Jan 30;2022:9334866. doi: 10.1155/2022/9334866. eCollection 2022.
To compare the ability of six preendoscopic scoring systems (ABC, AIMS65, Glasgow Blatchford score (GBS), MAP(ASH), pRS, and -score) to predict outcomes of upper gastrointestinal bleeding (UGIB) in older adults.
This was a retrospective study of 602 older adults (age ≥ 65) presenting with UGIB at Zhongda Hospital Southeast University from January 2015 to June 2021. Six scoring systems were used to analyze all patients.
ABC had the largest area under the curve (AUC) (0.833; 95% confidence interval (CI): 0.801-0.862) and was significantly higher than pRS 0.696 (95% CI: 0.658-0.733, < 0.01) and -score 0.667 (95% CI: 0.628-0.704, < 0.01) in predicting mortality. MAP(ASH) (0.783; 95% CI: 0.748-0.815) performs the best in predicting intervention and was similar to GBS, -score, ABC, and AIMS65. The AUCs for MAP(ASH) (0.732; 95% CI: 0.698-0.770), AIMS65 (0.711; 95% CI: 0.672-0.746), and ABC (0.718; 95% CI: 0.680-0.754) were fair for rebleeding, while those of GBS (0.662; 95% CI: 0.617-0.694), -score (0.641; 95% CI: 0.606-0.684), and pRS (0.609; 95% CI: 0.569-0.648) were performed poorly. MAP(ASH) performs the best in predicting ICU admission (0.784; 95% CI: 0.749-0.816). All the five scores were significantly higher than pRS ( < 0.05 for ABC, AIMS65 and -score, < 0.01 for GBS and MAP).
Mortality, intervention, rebleeding, and ICU admission in UGIB for older adults can be predicted well using MAP(ASH). ABC is the most accurate for predicting mortality. Except for rebleeding, GBS has an acceptable performance in predicting ICU admission, mortality, and intervention. AIMS65 and -score performed moderately, and pRS may not be suitable for the target cohort.
比较六种内镜前评分系统（ABC、AIMS65、格拉斯哥布拉奇福德评分（GBS）、MAP(ASH)、pRS和 -评分）预测老年上消化道出血（UGIB）患者预后的能力。
这是一项对2015年1月至2021年6月在东南大学附属中大医院就诊的602例老年（年龄≥65岁）UGIB患者的回顾性研究。使用六种评分系统对所有患者进行分析。
ABC曲线下面积（AUC）最大（0.833；95%置信区间（CI）：0.801 - 0.862），在预测死亡率方面显著高于pRS 0.696（95% CI：0.658 - 0.733，P < 0.01）和 -评分0.667（95% CI：0.628 - 0.704，P < 0.01）。MAP(ASH)（0.783；95% CI：0.748 - 0.815）在预测干预方面表现最佳，与GBS、 -评分、ABC和AIMS65相似。MAP(ASH)（0.732；95% CI：0.698 - 0.770）、AIMS65（0.711；95% CI：0.672 - 0.746）和ABC（0.718；95% CI：0.680 - 0.754）预测再出血的AUC尚可，而GBS（0.662；95% CI：0.617 - 0.694）、 -评分（0.641；95% CI：0.606 - 0.684）和pRS（0.609；95% CI：0.569 - 0.648）表现较差。MAP(ASH)在预测入住重症监护病房（ICU）方面表现最佳（0.784；95% CI：0.749 - 0.816）。所有这五个评分均显著高于pRS（ABC、AIMS65和 -评分为P < 0.05，GBS和MAP为P < 0.01）。
使用MAP(ASH)可以很好地预测老年UGIB患者的死亡率、干预、再出血和入住ICU情况。ABC在预测死亡率方面最准确。除再出血外，GBS在预测ICU入住、死亡率和干预方面表现尚可。AIMS65和 -评分表现中等，pRS可能不适用于该目标人群。
