评估四个风险评估得分在非瘤上胃肠道出血中的表现
Omer Kheir1, Mohammed Ghamdi1, Sheikha Dossary1
1Population Health, Johns Hopkins Aramco Healthcare, Dhahran, SAU.
Cureus
|July 3, 2025
概括
国家早期预警评分 (NEWS) 是预测非瘤上部胃肠道出血 (NVUGIB) 结果的最有效工具. 其他分数,如BAR,也有助于评估这些危急患者的输血需求.
科学领域:
- 胃肠病学 胃肠病学
- 关键护理医学 关键护理医学
- 临床风险分层的临床风险分层
背景情况:
- 非静脉上部胃肠道出血 (NVUGIB) 是一种严重的医疗紧急情况,患病率和死亡率很高.
- 现有的NVUGIB风险分层评分系统在紧急情况下的有效性不确定.
研究的目的:
- 为了比较四个评分系统的预测性能:BAR,PTAR,LTA和NEWS的NVUGIB结果.
- 确定NVUGIB患者初始风险分层的最可靠工具.
主要方法:
- 约翰霍普金斯阿兰科医疗的回顾性医院研究 (2020年1月 - 2023年9月).
- 包括18岁以上的非创伤性UGIB患者 (不包括癌症患者).
- 收集患者数据,生命体征,实验室结果,并发症和结局;计算和比较四个评分系统.
主要成果:
- 新闻报道显示,住院预测表现最高 (AUC 84%) 和90天死亡率 (AUC 77.2%).
- NEWS和BAR同样预测了输血需要 (AUC为71.7%).
- LTA对死亡率有很高的敏感性 (75%),PTAR提供了中等的预测值.
结论:
- NEWS是NVUGIB初始风险分层的可靠工具,其表现优于其他评估得分.
- 在评估输血需求时,BAR很有价值.
- 根据临床背景,LTA和PTAR可能提供互补的见解.
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