A Novel Easy-to-Use Prediction Scheme for Upper Gastrointestinal Bleeding

Hoffmann, V.; Neubauer, Henrik; Heinzler, Julia; Smarczyk, Anna; Hellmich, Martin; Bowe, Andrea; Kuetting, Fabian; Demir, Münevver; Pelc, A; Schulte, Sigrid; Toex, Ullrich; Nierhoff, Dirk; Steffen, Hans‐Michael

doi:10.1097/md.0000000000001614

Cited by 12 publications

(17 citation statements)

References 41 publications

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“…Low Hb (≤10 g/dl) at baseline is, as one would expect, predictive of subsequent anemia 18. Hb less than 10 g/dl has been shown to be an independent predictor for rebleeding, need for intervention, or death following AGIB 42. In these three groups, FCM alone achieved a mean Hb increase in the range 3.0–4.6 g/dl, and the mean Hb at follow-up was normal or close to normal.…”

Section: Discussionmentioning

confidence: 91%

Clinical experience with ferric carboxymaltose in the management of anemia in acute gastrointestinal bleeding

Ballester-Clau

Vicente

Voltà-Pardo

et al. 2019

European Journal of Gastroenterology &Amp; Hepatology

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ObjectiveThe aim of this study was to assess the efficacy and safety of intravenous ferric carboxymaltose (FCM) following hospitalization for acute gastrointestinal bleeding (AGIB) in the context of a restrictive transfusion strategy.Patients and methodsA retrospective single-center study analyzed patients with AGIB (excluding AGIB secondary to portal hypertension) administered a single FCM dose with or without blood transfusion.ResultsEighty-six episodes in 84 patients were analyzed. Seventy-nine patients had upper AGIB. Nineteen episodes were associated with hemodynamic instability. FCM was administered during hospitalization as a single dose of 1000 mg iron in 84/86 episodes and as a single dose of 500 mg iron in two episodes, with blood transfusion in 60/86 (69.8%) episodes. The mean hemoglobin (Hb) was 9.0 g/dl at admission, 7.6 g/dl at the lowest in-hospital value, 9.4 g/dl at discharge, and 12.7 g/dl at follow-up (mean: 55 days postdischarge) (P<0.001 for follow-up vs. all other timepoints). The lowest mean in-hospital Hb value was 7.2 and 8.8 g/dl, respectively, in patients with transfusion+FCM versus FCM alone; the mean Hb was 12.4 versus 13.7 g/dl at follow-up. In patients administered FCM alone, the mean Hb at follow-up in the subpopulations aged older than or equal to 75 years (n=33), Charlson comorbidity index of at least 3 (n=48), and Hb of up to 10 g/dl at admission (n=47) were 12.6, 13.1, and 13.3 g/dl, respectively. No adverse effects were detected.ConclusionTreatment with FCM for AGIB is associated with a good erythropoietic response and anemia correction after hospitalization, even in severe episodes or when transfusion is needed. FCM is safe and well tolerated, and may support a restrictive transfusion policy.

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Section: Discussionmentioning

confidence: 91%

Clinical experience with ferric carboxymaltose in the management of anemia in acute gastrointestinal bleeding

Ballester-Clau

Vicente

Voltà-Pardo

et al. 2019

European Journal of Gastroenterology &Amp; Hepatology

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“…While the incidence UGIB has been declining, mortality rate after UGIB has been maintained at approximately around 10%. [ 11 , 30 , 31 ] Several studies reported scoring systems as a way to predict the mortality of UGIB, which were large scale, multicenter studies and have undergone thorough validation processes. However, some scoring systems require endoscopic findings or more than 4 variables, or involve complex calculation.…”

Section: Discussionmentioning

confidence: 99%

C-reactive protein for simple prediction of mortality in patients with acute non-variceal upper gastrointestinal bleeding

et al. 2020

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“…Management approach to children presented with UGIB was influenced by adult studies due to lack of randomized controlled studies, systematic reviews, or Cochrane reviews in children . The scoring systems for adults presented with UGIB has not been applied to children because many scores relied on endoscopic findings and were unsuitable for early classification of patients; most of the physiological and hematological parameters on which they were based were not applicable to children . We tried to compare the scoring systems (Glasgow–Blatchford score, the clinical Rockall score, and AIMS) to a new scoring system.…”

Section: Discussionmentioning

confidence: 99%

“…Yearly incidence of UGIB ranges from 10–18/10 000 in adults in comparison with 1–2/10 000 in children . The most frequent causes are peptic ulcers (46%), followed by esophagitis and erosions in adults . For children, the etiology of UGIB varies in different parts of the world, presenting geographical alterations in common disease states …”

Section: Introductionmentioning

confidence: 99%

“…5,6 The most frequent causes are peptic ulcers (46%), followed by esophagitis and erosions in adults. 7 For children, the etiology of UGIB varies in different parts of the world, presenting geographical alterations in common disease states. 3 Concerning adults with UGIB, reliable predictive scoring systems (Rockall, Blatchford, and Addenbrooke) exist to identify which patients are high risk (of mortality, repeat bleeding, need for blood transfusion, and surgical intervention) and enable predictions for endoscopic intervention.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of risk factors and development of scoring system to predict severity of upper gastrointestinal bleeding in children

Zheng

Jiang

Jia

et al. 2018

J of Gastro and Hepatol

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Background and Aim Upper gastrointestinal bleeding is a rare and potentially life‐threatening condition in children. Herein, clinical features and risk factors in children with upper gastrointestinal bleeding were analyzed, and a clinical scoring system was constructed to assess severity. Methods This retrospective cohort study involved 224 children hospitalized with upper gastrointestinal bleeding between January 2012 and April 2018. Demographic data, clinical information, and laboratory test results on admission were statistically examined. Results Out of 224 upper gastrointestinal bleeding cases, 76 were diagnosed as severe and 148 as mild cases according to the rate of blood loss and severity. Severe group was significantly different from mild group in 23 items including age, number of patients aged more than 7 years, and so forth (P < 0.01 or P < 0.05). Positive detection rate of bleeding etiology was gradually decreased (P < 0.01) in relation to delay in timing of endoscopy. Analysis of logistic regression evinced five independent risk factors for severe cases to be associated with poor consciousness, hemoglobin < 80 g/L, hemoglobin drop of > 20 g/L, hematochezia, and anemic appearance (P < 0.01 or P < 0.05). Using these five parameters, a number of scoring models were tested. The most predictive resulted in a scoring system constructed with a total of 16 and a cutoff for intervention of 8. Conclusions Amalgamation of risk factors with the scoring system plays an important role in assessing upper gastrointestinal bleeding severity in children.

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A Novel Easy-to-Use Prediction Scheme for Upper Gastrointestinal Bleeding

Abstract: Supplemental Digital Content is available in the text

Cited by 12 publications

References 41 publications

Clinical experience with ferric carboxymaltose in the management of anemia in acute gastrointestinal bleeding

Clinical experience with ferric carboxymaltose in the management of anemia in acute gastrointestinal bleeding

C-reactive protein for simple prediction of mortality in patients with acute non-variceal upper gastrointestinal bleeding

Analysis of risk factors and development of scoring system to predict severity of upper gastrointestinal bleeding in children

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