在患上上部胃肠道出血的老年患者中,前内镜评分系统的极限
Giuseppe Di Gioia1, Moris Sangineto2, Annalisa Paglia1,3
1Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Scientific reports
|August 30, 2024
概括
目前的上部胃肠道出血 (UGIB) 风险评分在老年人中表现不佳. 这项研究发现,常见的评分系统在预测患有UGIB的老年人的结果方面缺乏准确性,这突显了需要包括年龄在内的评估的需要.
科学领域:
- 胃肠病学 胃肠病学
- 老年医学 老年医学
- 临床流行病学 临床流行病学
背景情况:
- 上部胃肠道出血 (UGIB) 是全球常见的住院原因.
- 现有的UGIB风险评分往往忽略了老年人群,这是一个高风险群体.
- 准确预测UGIB结果对于有效的患者管理至关重要.
研究的目的:
- 为了比较6种常见的前内镜风险评分系统在住院老年患者的预测准确度.
- 评估这些分数在预测30天死亡率,综合结果和不同年龄组住院时间的表现.
主要方法:
- 一项多中心,横截面研究,涉及136名住院患UGIB的患者.
- 患者被分为两个队列:65-81.9岁 (<82岁) 和82-100岁 (≥82岁).
- 应用了六个风险评分 (格拉斯哥-布拉奇福德,修改的布拉奇福德,T-score,MAP,ASH,CANUKA,AIMS65) 并评估了它们的预测准确性.
主要成果:
- 与<82岁组相比,T-score在预测≥82岁组的死亡率方面显示出明显较差的准确性.
- 除了T分数外,年轻的参与者对复合结果预测的敏感性通常更高.
- 所有风险评分都在预测逗留时间方面表现不佳,大多数评分在年龄队列之间存在显著的准确差异.
结论:
- 广泛使用的UGIB风险评分在预测老年人群中临床相关结果时的准确性较低.
- 针对UGIB的新风险评分系统应将年龄或晚年作为关键评估因素纳入.
- 需要为经历上部胃肠道出血的老年患者开发和验证特定年龄的风险预测工具.
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