前内镜评分预测高胃肠道出血的低风险患者:系统性审查和元分析
Antoine Boustany1, Ali A Alali2, Majid Almadi3
1Department of Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
格拉斯哥-布拉奇福德评分 (GBS) 是识别低风险急性上胃肠道出血 (UGIB) 患者的最佳工具. 一个GBS的1或更少是理想的,但一个切断的2允许更多的患者安全地管理作为门诊.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 基于证据的医学基于证据的医学.
背景情况:
- 急性上部胃肠道出血 (UGIB) 的管理需要准确的风险分层来识别需要干预的患者.
- 一些前内镜风险评分旨在预测UGIB患者的不良结果,但它们的比较疗效尚不清楚.
研究的目的:
- 系统地审查和比较前内镜风险评分的预测能力,以预测UGIB患者缺少不良事件的预后.
- 评估格拉斯哥-布拉奇福德 (GBS),临床罗卡尔 (CRS),AIMS65和ABC等得分的准确性,以确定低风险的UGIB患者.
主要方法:
- 一个系统的审查和对已发表的研究的元分析,评估UGIB患者的前内镜分数.
- 搜索了MEDLINE,EMBASE,中央和ISI知识网络,截至2023年2月.
- 主要结局:医院干预的综合评分;次要结局:死亡率,再出血.
主要成果:
- 包括38项涉及36215名患者的研究.
- 低的GBS切断值 (0, ≤1, ≤2) 与很少的医院干预 (0.02-0.04) 有关.
- 整体医疗分析显示出对预测医院干预的需求有很好的区分能力,并且在二次结果中通常是最准确的.
结论:
- 一个GBS截止值为1或更低最好识别低风险的UGIB患者.
- 将GBS截止值扩大到2保持预后准确性,并允许对更多患者进行安全的门诊治疗.
- 由于数据质量和通用性的局限性,需要进行进一步的比较和干预研究.
更多相关视频
15:49Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System
Published on: October 16, 2013
09:50Induction of Intestinal Graft-versus-host Disease and Its Mini-endoscopic Assessment in Live Mice
Published on: February 11, 2019
相关概念视频
Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Lower GI Series: Barium Enema
Procedure Details
The examination begins by inserting a lubricated rectal tube into the patient's rectum to administer a radiopaque barium solution. The barium flow is carefully...
Endoscopic Procedures V: ERCP
Patient...
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
