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新型ABC和MAP(ASH)评分在上消化道出血相关结局预测中的表现

Performance of the New ABC and MAP(ASH) Scores in the Prediction of Relevant Outcomes in Upper Gastrointestinal Bleeding.

作者信息

Jimenez-Rosales Rita, Lopez-Tobaruela Jose Maria, Lopez-Vico Manuel, Ortega-Suazo Eva Julissa, Martinez-Cara Juan Gabriel, Redondo-Cerezo Eduardo

机构信息

Department of Gastroenterology, "Virgen de las Nieves" University Hospital, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain.

University of Granada, 18010 Granada, Spain.

出版信息

J Clin Med. 2023 Jan 30;12(3):1085. doi: 10.3390/jcm12031085.

Abstract

: Several risk scores have been proposed for risk-stratification of patients with upper gastrointestinal bleeding. ABC score was found more accurate predicting mortality than AIMS65. MAP(ASH) is a simple, pre-endoscopy score with a great ability to predict intervention and mortality. The aim of this study was to compare ABC and MAP(ASH) discriminative ability for the prediction of mortality and intervention in UGIB. As a secondary aim we compared both scores with Glasgow-Blatchford score and AIMS65. : Our study included patients admitted to the emergency room of Virgen de las Nieves University Hospital with UGIB (2017-2020). Information regarding clinical, biochemical tests and procedures was collected. Main outcomes were in-hospital mortality and a composite endpoint for intervention. : MAP(ASH) and ABC had similar AUROCs for mortality (0.79 vs. 0.80). For intervention, MAP(ASH) (AUROC = 0.75) and ABC (AUROC = 0.72) were also similar. Regarding rebleeding, AUROCs of MAP(ASH) and ABC were 0.67 and 0.61 respectively. No statistically differences were found in these outcomes. With a low threshold for MAP(ASH) ≤ 2, ABC and MAP(ASH) classified a similar proportion of patients as being at low risk of death (42% vs. 45.2%), with virtually no mortality under these thresholds. : MAP(ASH) and ABC were similar for the prediction of relevant outcomes for UGIB, such as intervention, rebleeding and in-hospital mortality, with an accurate selection of low-risk patients. MAP(ASH) has the advantage of being easier to calculate even without the aid of electronic tools.

摘要

针对上消化道出血患者的风险分层,已经提出了几种风险评分系统。研究发现,ABC评分在预测死亡率方面比AIMS65更为准确。MAP(ASH)是一种简单的内镜检查前评分系统,具有很强的预测干预措施和死亡率的能力。本研究的目的是比较ABC评分和MAP(ASH)在预测上消化道出血患者死亡率和干预措施方面的鉴别能力。作为次要目的,我们将这两种评分与格拉斯哥-布拉奇福德评分和AIMS65进行了比较。:我们的研究纳入了2017年至2020年因上消化道出血入住比维斯·德拉斯涅韦斯大学医院急诊室的患者。收集了有关临床、生化检查和诊疗程序的信息。主要结局指标为住院死亡率和干预综合终点。:MAP(ASH)和ABC在预测死亡率方面的曲线下面积(AUROC)相似(分别为0.79和0.80)。对于干预措施的预测,MAP(ASH)(AUROC = 0.75)和ABC(AUROC = 0.72)也相似。关于再出血,MAP(ASH)和ABC的AUROC分别为0.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d62c/9917936/8e7474eec646/jcm-12-01085-g001.jpg

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