Comparison of the National Early Warning Score+Lactate score with the pre-endoscopic Rockall, Glasgow-Blatchford, and AIMS65 scores in patients with upper gastrointestinal bleeding
Clinical and Experimental Emergency Medicine
; (4): 219-229, 2018.
Article
em En
| WPRIM
| ID: wpr-718718
Biblioteca responsável:
WPRO
ABSTRACT
OBJECTIVE:
We compared the predictive value of the National Early Warning Score+Lactate (NEWS+L) score with those of other parameters such as the pre-endoscopic Rockall score (PERS), Glasgow-Blatchford score (GBS), and albumin, international normalized ratio, altered mental status, systolic blood pressure, age older than 65 years score (AIMS65) among patients with upper gastrointestinal bleeding (UGIB).METHODS:
We conducted a retrospective study of patients with UGIB during 2 consecutive years. The primary outcome was the composite of in-hospital death, intensive care unit admission, and the need for ≥5 packs of red blood cell transfusion within 24 hours.RESULTS:
Among 530 included patients, the composite outcome occurred in 59 patients (19 in-hospital deaths, 13 intensive care unit admissions, and 40 transfusions of ≥5 packs of red blood cells within 24 hours). The area under the receiver operating characteristic curve of the NEWS+L score for the composite outcome was 0.76 (95% confidence interval, 0.70 to 0.82), which demonstrated a significant difference compared to PERS (0.66, 0.59–0.73, P=0.004), but not to GBS (0.70, 0.64–0.77, P=0.141) and AIMS65 (0.76, 0.70–0.83, P=0.999). The sensitivities of NEWS+L scores of 3 (n=34, 6.4%), 4 (n=92, 17.4%), and 5 (n=171, 32.3%) were 100%, 98.3%, and 96.6%, respectively, while the sensitivity of an AIMS65 score of 0 (n=159, 30.0%) was 91.5%.CONCLUSION:
The NEWS+L score showed better discriminative performance than the PERS and comparable discriminative performance to the GBS and AIMS65. The NEWS+L score may be used to identify low-risk patients among patients with UGIB.Palavras-chave
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Índice:
WPRIM
Assunto principal:
Pressão Sanguínea
/
Estudos Retrospectivos
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Curva ROC
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Mortalidade
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Transfusão de Eritrócitos
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Ácido Láctico
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Coeficiente Internacional Normatizado
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Eritrócitos
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Hemorragia
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Unidades de Terapia Intensiva
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Clinical and Experimental Emergency Medicine
Ano de publicação:
2018
Tipo de documento:
Article