Validation and modification of existing mortality prediction models for lower gastrointestinal bleeding: a retrospective study

Abstract Background Lower gastrointestinal bleeding (LGIB) often subsides without medical intervention; however, in some cases, the bleeding does not stop and the patient’s condition worsens. Therefore, predicting severe LGIB in advance can aid treatment. This study aimed to evaluate variables relat...

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Autores principales:	Hyun Seok Lee, Hee Seok Moon, In Sun Kwon, Hyun Yong Jeong, Byung Seok Lee, Seok Hyun Kim, Eaum-Seok Lee, Jae Kyu Sung, Sun Hyung Kang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Lower gastrointestinal bleeding hematochezia Scoring system Mortality prediction Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/569e5193768a4b8bafb6cee1f1468719
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spelling	oai:doaj.org-article:569e5193768a4b8bafb6cee1f14687192021-12-05T12:10:59ZValidation and modification of existing mortality prediction models for lower gastrointestinal bleeding: a retrospective study10.1186/s12876-021-02037-41471-230Xhttps://doaj.org/article/569e5193768a4b8bafb6cee1f14687192021-11-01T00:00:00Zhttps://doi.org/10.1186/s12876-021-02037-4https://doaj.org/toc/1471-230XAbstract Background Lower gastrointestinal bleeding (LGIB) often subsides without medical intervention; however, in some cases, the bleeding does not stop and the patient’s condition worsens. Therefore, predicting severe LGIB in advance can aid treatment. This study aimed to evaluate variables related to mortality from LGIB and propose a scoring system. Methods In this retrospective study, we reviewed the medical records of patients who visited the emergency room with hematochezia between January 2016 and December 2020. Through regression analysis of comorbidities, medications, vital signs, laboratory investigations, and duration of hospital stay, variables related to LGIB-related mortality were evaluated. A scoring system was developed and the appropriateness with an area under the receiver operating characteristics curve (AUROC) was evaluated and compared with other existing models. Results A total of 932 patients were hospitalized for LGIB. Variables associated with LGIB-related mortality were the presence of cancer, heart rate > 100 beats/min, blood urea nitrogen level ≥ 30 mg/dL, an international normalized ratio > 1.50, and albumin level ≤ 3.0 g/dL. The AUROCs of the models CNUH-4 and CNUH-5 were 0.890 (p < 0.001; cutoff, 2.5; 95% confidence interval, 0.0851–0.929) and 0.901 (p < 0.001; cutoff, 3.5; 95% confidence interval, 0.869–0.933), respectively. Conclusions The model developed for predicting the risk of LGIB-related mortality is simple and easy to apply clinically. The AUROC of the model was better than that of the existing models.Hyun Seok LeeHee Seok MoonIn Sun KwonHyun Yong JeongByung Seok LeeSeok Hyun KimEaum-Seok LeeJae Kyu SungSun Hyung KangBMCarticleLower gastrointestinal bleedinghematocheziaScoring systemMortality predictionDiseases of the digestive system. GastroenterologyRC799-869ENBMC Gastroenterology, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Lower gastrointestinal bleeding hematochezia Scoring system Mortality prediction Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Lower gastrointestinal bleeding hematochezia Scoring system Mortality prediction Diseases of the digestive system. Gastroenterology RC799-869 Hyun Seok Lee Hee Seok Moon In Sun Kwon Hyun Yong Jeong Byung Seok Lee Seok Hyun Kim Eaum-Seok Lee Jae Kyu Sung Sun Hyung Kang Validation and modification of existing mortality prediction models for lower gastrointestinal bleeding: a retrospective study
description	Abstract Background Lower gastrointestinal bleeding (LGIB) often subsides without medical intervention; however, in some cases, the bleeding does not stop and the patient’s condition worsens. Therefore, predicting severe LGIB in advance can aid treatment. This study aimed to evaluate variables related to mortality from LGIB and propose a scoring system. Methods In this retrospective study, we reviewed the medical records of patients who visited the emergency room with hematochezia between January 2016 and December 2020. Through regression analysis of comorbidities, medications, vital signs, laboratory investigations, and duration of hospital stay, variables related to LGIB-related mortality were evaluated. A scoring system was developed and the appropriateness with an area under the receiver operating characteristics curve (AUROC) was evaluated and compared with other existing models. Results A total of 932 patients were hospitalized for LGIB. Variables associated with LGIB-related mortality were the presence of cancer, heart rate > 100 beats/min, blood urea nitrogen level ≥ 30 mg/dL, an international normalized ratio > 1.50, and albumin level ≤ 3.0 g/dL. The AUROCs of the models CNUH-4 and CNUH-5 were 0.890 (p < 0.001; cutoff, 2.5; 95% confidence interval, 0.0851–0.929) and 0.901 (p < 0.001; cutoff, 3.5; 95% confidence interval, 0.869–0.933), respectively. Conclusions The model developed for predicting the risk of LGIB-related mortality is simple and easy to apply clinically. The AUROC of the model was better than that of the existing models.
format	article
author	Hyun Seok Lee Hee Seok Moon In Sun Kwon Hyun Yong Jeong Byung Seok Lee Seok Hyun Kim Eaum-Seok Lee Jae Kyu Sung Sun Hyung Kang
author_facet	Hyun Seok Lee Hee Seok Moon In Sun Kwon Hyun Yong Jeong Byung Seok Lee Seok Hyun Kim Eaum-Seok Lee Jae Kyu Sung Sun Hyung Kang
author_sort	Hyun Seok Lee
title	Validation and modification of existing mortality prediction models for lower gastrointestinal bleeding: a retrospective study
title_short	Validation and modification of existing mortality prediction models for lower gastrointestinal bleeding: a retrospective study
title_full	Validation and modification of existing mortality prediction models for lower gastrointestinal bleeding: a retrospective study
title_fullStr	Validation and modification of existing mortality prediction models for lower gastrointestinal bleeding: a retrospective study
title_full_unstemmed	Validation and modification of existing mortality prediction models for lower gastrointestinal bleeding: a retrospective study
title_sort	validation and modification of existing mortality prediction models for lower gastrointestinal bleeding: a retrospective study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/569e5193768a4b8bafb6cee1f1468719
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Validation and modification of existing mortality prediction models for lower gastrointestinal bleeding: a retrospective study

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