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Glasgow-Blatchford Score Predicts Post-Discharge Gastrointestinal Bleeding in Hospitalized Patients with Heart
Yu Hotsuki1, Yu Sato1, Akiomi Yoshihisa1,2
1Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima 960-1247, Japan.
Insights
The Glasgow-Blatchford Score (GBS) can predict gastrointestinal bleeding (GIB) in heart failure (HF) patients after discharge. A high GBS score independently indicates a higher risk of GIB in this population.
Area of Science:
- Cardiology
- Gastroenterology
- Clinical Risk Stratification
Background:
- The Glasgow-Blatchford Score (GBS) is a common tool for assessing gastrointestinal bleeding (GIB) risk.
- Its utility in patients with heart failure (HF) is not well-established.
Purpose of the Study:
- To investigate the effectiveness of the GBS in predicting post-discharge GIB in patients with acute decompensated HF.
- To determine if GBS is an independent predictor of GIB in this specific patient group.
Main Methods:
- Prospective observational study of 2236 patients with acute decompensated HF.
- GBS calculated using standard parameters; patients stratified by GBS score (≤6 vs. >6).
- Kaplan-Meier and multivariate Cox proportional hazards analyses used for outcome assessment over a median 1235-day follow-up.
Main Results:
- Seventy-eight (3.5%) patients experienced GIB post-discharge.
- A GBS cutoff of six effectively stratified risk.
- High GBS ( > 6) was associated with significantly higher GIB rates (HR 2.258, p=0.003).
Conclusions:
- The Glasgow-Blatchford Score is a valuable tool for stratifying GIB risk in heart failure patients.
- Elevated GBS independently predicts post-discharge GIB in individuals with HF.
Background:
The Glasgow-Blatchford Score (GBS) is one of the most widely used scoring systems for predicting clinical outcomes for gastrointestinal bleeding (GIB). However, the clinical significance of the GBS in predicting GIB in patients with heart failure (HF) remains unclear.
Methods And Results:
We conducted a prospective observational study in which we collected the clinical data of a total of 2236 patients (1130 men, median 70 years old) who were admitted to Fukushima Medical University Hospital for acute decompensated HF. During the post-discharge follow-up period of a median of 1235 days, seventy-eight (3.5%) patients experienced GIB. The GBS was calculated based on blood urea nitrogen, hemoglobin, systolic blood pressure, heart rate, and history of hepatic disease. The survival classification and regression tree analysis revealed that the accurate cut-off point of the GBS in predicting post-discharge GIB was six points. The patients were divided into two groups: the high GBS group (GBS > 6, n = 702, 31.4%) and the low GBS group (GBS ≤ 6, n = 1534, 68.6%). The Kaplan-Meier analysis showed that GIB rates were higher in the high GBS group than in the low GBS group. Multivariate Cox proportional hazards analysis adjusted for age, malignant tumor, and albumin indicated that a high GBS was an independent predictor of GIB (hazards ratio 2.258, 95% confidence interval 1.326-3.845, p = 0.003).
Conclusions:
A high GBS is an independent predictor and useful risk stratification score of post-discharge GIB in patients with HF.
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