Development and internal validation of a risk scoring system for gastrointestinal events requiring surgery in gastrointestinal lymphoma patients

Aoki, Tomonori; Yamada, Atsuo; Takahashi, Miwako; Niikura, Ryota; Toyama, Kazuhiro; Ushiku, Tetsuo; Kurokawa, Mineo; Momose, Toshimitsu; Fukayama, Masashi; Koike, Kazuhiko

doi:10.1111/jgh.14452

Cited by 6 publications

(6 citation statements)

References 25 publications

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“…No corticoids have been used in these patients. To check the performance and validity of our prediction model, we opted for an internal validation method using an Operating Characteristic Curve [ 10 ]. Thus, the prediction model was tested on a new cohort of patients in the following 3 months after the initial data collection.…”

Section: Methodsmentioning

confidence: 99%

Predictive Value of Comorbid Conditions for COVID-19 Mortality

Marincu

Bratosin

Vidican

et al. 2021

JCM

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In this paper, we aim at understanding the broad spectrum of factors influencing the survival of infected patients and the correlations between these factors to create a predictive probabilistic score for surviving the COVID-19 disease. Initially, 510 hospital admissions were counted in the study, out of which 310 patients did not survive. A prediction model was developed based on this data by using a Bayesian approach. Following the data collection process for the development study, the second cohort of patients totaling 541 was built to validate the risk matrix previously created. The final model has an area under the curve of 0.773 and predicts the mortality risk of SARS-CoV-2 infection based on nine disease groups while considering the gender and age of the patient as distinct risk groups. To ease medical workers’ assessment of patients, we created a visual risk matrix based on a probabilistic model, ranging from a score of 1 (very low mortality risk) to 5 (very high mortality risk). Each score comprises a correlation between existing comorbid conditions, the number of comorbid conditions, gender, and age group category. This clinical model can be generalized in a hospital context and can be used to identify patients at high risk for whom immediate intervention might be required.

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Section: Methodsmentioning

confidence: 99%

Predictive Value of Comorbid Conditions for COVID-19 Mortality

Marincu

Bratosin

Vidican

et al. 2021

JCM

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“…Hasta el momento no existe una escala validada para predecir el riesgo de complicaciones en los pacientes con linfoma gastrointestinal. En el estudio de Aoki et al 5 , describieron que en el 48 % de los pacientes la presentación inicial fue por una de las complicaciones y en 52 % las complicaciones se desarrollaron posterior al inicio de la quimioterapia. Este mismo grupo evaluó los factores de riesgo de requerir cirugía por complicaciones gastrointestinales del linfoma y propusieron un puntaje de riesgo, que por ahora, solo cuenta con validación interna, denominado el "FLASH score" que incluye: A: Apariencia focal y tamaño mayor o igual de 40 mm (1 punto); B: Linfoma del intestino delgado con histología agresiva (2 puntos); C: Alta captación de las lesiones en la Tomografía de positrones con 18F-fluorodesoxiglucosa (1 punto).…”

Section: Discussionunclassified

“…La afectación gastrointestinal primaria del linfoma no Hodgkin es la ubicación extraganglionar más frecuente, causando un 30 % a 40 %, mientras el compromiso secundario se reporta entre el 10 % a 15 % 4 . El linfoma Hodgkin con afectación gastrointestinal es extremadamente raro 5 .…”

Section: Introductionunclassified

“…El papel de las intervenciones quirúrgicas ha cambiado con los años. La cirugía es fundamental cuando se presenta alguna complicación como perforación intestinal, obstrucción intestinal o sangrado digestivo, documentadas hasta en el 20 % de los pacientes con linfoma con compromiso gastrointestinal 4,5 . La literatura disponible desde el enfoque quirúrgico no es extensa, por lo cual, el objetivo de esta revisión fue describir las principales complicaciones de interés para el cirujano.…”

Section: Introductionunclassified

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Complicaciones quirúrgicas del linfoma con compromiso gastrointestinal

Molina-Valencia

Delgado-López

2021

Rev Colomb Cir

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Introducción. El linfoma puede afectar el tracto gastrointestinal de manera primaria o secundaria, y representa hasta el 2 % de todas las neoplasias malignas del intestino delgado y colon. El tracto gastrointestinal es la ubicación extraganglionar primaria más común en el linfoma no Hodgkin. Métodos. Se realizó una búsqueda de la literatura en las principales bases de datos académicas, con revisión de textos publicados sobre el tema en los últimos 5 años. Discusión. La presentación clínica del linfoma con compromiso gastrointestinal es inespecífica y, hasta en la mitad de los pacientes, se puede presentar de manera inicial con complicaciones que requieran manejo quirúrgico. Entre las principales se encuentran la perforación intestinal, el sangrado digestivo y la obstrucción intestinal.

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“…1 ) [ 9 ]. The criteria for choosing conservative management for patients with bowel perforation included: 1, good general health; 2, no signs of diffuse peritonitis; and 3, localized intra-abdominal free gas according to imaging examination, and no obstruction [ 13 – 15 ]. Close monitoring within the first 24 h of treatment was mandatory to allow early detection of conservative treatment failure.…”

Section: Methodsmentioning

confidence: 99%

Clinical features and outcomes of bowel perforation in primary pediatric gastrointestinal lymphoma

et al. 2021

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Background Whether surgery can improve the prognosis of patients with primary pediatric gastrointestinal lymphoma (PPGL) who experienced bowel perforation remains controversial. This study aimed to evaluate the prognosis of such patients. Methods Nine patients pathologically diagnosed with PPGL who experienced perforation at our center between January 2010 and December 2020 were enrolled and divided into two groups: those with perforation during (n = 4) and before (n = 5) chemotherapy. Their medical records were reviewed, and long-term follow-up was conducted by telephone in February 2021. Results All patients with perforation during chemotherapy were diagnosed with PPGL in the outpatient department. The mean time from outpatient visit to chemotherapy was 17.3 ± 6.1 days. Two patients experienced perforation during the first chemotherapy regimen and received conservative treatment, while the others developed perforation after multiple chemotherapy regimens and underwent surgery. All of the patients received regular chemotherapy and survived for a mean follow-up time of 3.8 ± 1.9 years. No patient with perforation before chemotherapy had a definite diagnosis in the outpatient department. Among these patients, 4 experienced perforation and underwent surgery, of whom 3 developed perforation-related complications and died; the other recurred after chemotherapy. Only the patient who received conservative treatment was diagnosed with PPGL before chemotherapy, received regular chemotherapy, and survived without a recurrence for 1.0 year. Conclusion Prompt diagnosis and chemotherapy improve the prognosis of PPGL. Surgery does not affect the prognosis of patients with perforation during chemotherapy but may accelerate disease progression in patients with perforation before chemotherapy.

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Development and internal validation of a risk scoring system for gastrointestinal events requiring surgery in gastrointestinal lymphoma patients

Abstract: We developed and internally validated a risk scoring system (the FLASH score) that included macroscopic findings to predict severe GI events in GI lymphoma patients. Patients with high scores are candidates for elective surgery to prevent GI events.

Cited by 6 publications

References 25 publications

Predictive Value of Comorbid Conditions for COVID-19 Mortality

Predictive Value of Comorbid Conditions for COVID-19 Mortality

Complicaciones quirúrgicas del linfoma con compromiso gastrointestinal

Clinical features and outcomes of bowel perforation in primary pediatric gastrointestinal lymphoma

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