Usefulness of the CHAMPS score for risk stratification in lower gastrointestinal bleeding

Area of Science:

• Gastroenterology
• Clinical Medicine
• Predictive Analytics

Background:

• In-hospital mortality prediction is crucial for managing lower gastrointestinal bleeding (LGIB).
• Existing prediction scores often lack specific validation for LGIB patient populations.

Purpose of the Study:

• To evaluate the utility of the CHAMPS score, initially developed for upper gastrointestinal bleeding, in predicting in-hospital mortality among patients with LGIB.
• To compare the predictive performance of the CHAMPS score against established risk stratification tools in LGIB.

Main Methods:

• Retrospective analysis of consecutive adult patients hospitalized with LGIB between 2015 and 2020 at two tertiary academic medical centers.
• Performance assessment using receiver operating characteristic (ROC) curve analysis to determine the area under the curve (AUC).
• Comparison of CHAMPS score performance against four pre-existing risk scores.

Main Results:

• The study included 387 patients, with 39 (10.1%) experiencing in-hospital mortality.
• The CHAMPS score demonstrated strong predictive performance for in-hospital mortality in LGIB patients, achieving an AUC of 0.80 (95% CI: 0.73-0.87).
• CHAMPS score significantly outperformed existing scores, with distinct risk categories identified: low risk (≤1) 1.8%, intermediate risk (2 or 3) 15.8%, and high risk (≥4) 37.1% mortality.

Conclusions:

• The CHAMPS score is a valuable and effective tool for predicting in-hospital mortality in patients diagnosed with lower gastrointestinal bleeding.
• The validated performance of the CHAMPS score in an LGIB cohort supports its clinical utility for risk stratification and patient management.