四种评分系统的比较,用于患有非变节性上胃肠道出血的患者
Elrasheed M Elsabani1, Badr A Badr2, Mohammad Dhalaan3
1Hospital Medicine, Johns Hopkins Aramco Healthcare, Dhahran, SAU.
Cureus
|December 2, 2024
概括
这项研究比较了上部胃肠道出血 (UGIB) 的风险得分. 格拉斯哥 - 布拉奇福德得分 (GBS) 最好预测输血,而国家早期预警得分 (NEWS) 预测了入院和死亡率.
科学领域:
- 胃肠病学 胃肠病学
- 关键护理医学 关键护理医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 上部胃肠道出血 (UGIB) 是死亡率和发病率的重要原因.
- 准确的风险分层对于管理UGIB患者和有效分配资源至关重要.
- 现有的风险评估工具,包括格拉斯哥-布拉奇福德评分 (GBS),AIMS65,国家早期预警评分 (NEWS) 和NEWS + Lactate (NEWS+L),具有不同的优势和局限性.
研究的目的:
- 评估和比较GBS,AIMS65,NEWS和NEWS+L的预测性表现,以评估非瘤上部胃肠道出血 (NVUGIB) 的关键结果.
- 评估这些得分在预测需要输血,住院住院和90天死亡率方面的准确性.
主要方法:
- 对229名NVUGIB患者进行了回顾性审查.
- 收集了人口统计数据,临床表现,实验室值和生命体征.
- 每位患者的GBS,AIMS65,NEWS和NEWS+L分数都被计算出来,并使用接收器运行特征曲线 (AUC) 评估它们的预测准确性.
主要成果:
- 格拉斯哥-布拉奇福德得分 (GBS) 显示了输血的最高预测准确度 (AUC:75.7%).
- 国家早期预警分数 (NEWS) 是住院患者入院的最佳预测指标 (AUC:84.04%).
- 对于90天死亡率,NEWS和NEWS+L显示了类似的预测性能 (AUC分别为77.25%和77.52%),表现优于GBS和AIMS65.
结论:
- 每个风险分数都具有不同的预测能力,用于NVUGIB中的特定结果.
- 在预测输血需求方面,GBS是最准确的,在入院方面,NEWS是最准确的,在死亡率方面,NEWS/NEWS+L是最准确的.
- 结合这些得分可能会提高风险分层和指导向治疗,最终改善UGIB患者的治疗结果.
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