Validation of the new ABC score for predicting 30-day mortality in gastrointestinal bleeding

Saadé, Marie Christelle; Kerbage, Anthony; Jabak, Suha; Makki, Maha; Barada, Kassem; Shaib, Yasser H

doi:10.1186/s12876-022-02374-y

Cited by 11 publications

(9 citation statements)

References 17 publications

(19 reference statements)

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“…On the contrary, early recognition of high-risk patients requiring urgent hospitalization and intervention prevents delays in treatment, thus reducing morbidity and mortality 15 . In the high-risk patient group of the ABC score, which has the highest AUC value in this study, the in-hospital mortality rate was 22.9%, which is consistent with the literature 10,16 ABC: age, blood tests, and comorbidities; AIMS65: albumin level <30 g/L (A), international normalized ratio >1.5 (I), altered mental status (M), systolic blood pressure ≤90 mmHg (S), and age >65 years (65); ASA: American Society of Anesthesiologists. CHAMPS: CCI ≥2, in-hospital onset, albumin <2.5 g/dL, altered mental status, ECOG-PS ≥2, steroids; CCI: Charlson Comorbidity Index; ECOG-PS: Eastern Cooperative Oncology Group Performance Status; INR: international normalized ratio; IQR: interquartile range; NSAIDs: nonsteroidal anti-inflammatory drugs, SD: standard deviation.…”

Section: Discussionsupporting

confidence: 91%

CHAMPS score in predicting mortality of patients with acute nonvariceal upper gastrointestinal bleeding

Aydın

Berikol

Erdogan

et al. 2023

Rev. Assoc. Med. Bras.

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OBJECTIVE:The aim of this study was to evaluate the performance of the Charlson Comorbidity Index ≥2, in-hospital onset, albumin <2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥2, steroid use score in predicting mortality in patients with nonvariceal upper gastrointestinal bleeding and compare it with the Glasgow-Blatchford score; the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score; the age, blood tests, and comorbidities score; and Complete Rockall score. METHODS: The data of patients with acute upper gastrointestinal bleeding who visited the emergency department during the study period were obtained from the hospital automation system by using the classification of disease codes and analyzed in this retrospective study. Adult patients with endoscopically confirmed nonvariceal upper gastrointestinal bleeding were included in the study. Patients with bleeding from the tumor, bleeding after endoscopic resection, or missing data were excluded. The prediction accuracy of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/ dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score was calculated using the area under the receiver operating characteristic curve and compared with that of Glasgow-Blatchford score, the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score, the age, blood tests, and comorbidities score, and Complete Rockall score. RESULTS: A total of 805 patients were included in the study, and the in-hospital mortality rate was 6.6%. The performance of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score (area under the receiver operating characteristic curve 0.812, 95%CI 0.783-0.839) was better than Glasgow-Blatchford score (area under the receiver operating characteristic curve 0.683, 95%CI 0.650-0.713, p=0.008), and similar to the the age, blood tests, and comorbidities score (area under the receiver operating characteristic curve 0.829, 95%CI 0.801-0.854, p=0.563), the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score (area under the receiver operating characteristic curve 0.794, 95%CI 0.764-0.821, p=0.672), and Complete Rockall score (area under the receiver operating characteristic curve 0.761, 95%CI 0.730-0.790, p=0.106). CONCLUSION: The performance of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score in predicting in-hospital mortality for our study population is better than Glasgow-Blatchford score and similar to the the age, blood tests, and comorbidities score, the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 6...

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Section: Discussionsupporting

confidence: 91%

CHAMPS score in predicting mortality of patients with acute nonvariceal upper gastrointestinal bleeding

Aydın

Berikol

Erdogan

et al. 2023

Rev. Assoc. Med. Bras.

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“…For example, the average score in the study by Li Y. et al (2022) was 4.0 [24], Saade M.C. et al reported 5.26 [9], and Jimenez-Rosales R. et al (2023) reported 4.5 [25]. It is evident that the average ABC score in our study is significantly higher, and this difference may arise from the criteria for selecting patients to participate in this study.…”

Section: Discussionmentioning

confidence: 44%

“…Additionally, compared to other scoring systems like AIMS65, Rockall, and Glasgow-Blatchford, the ABC score demonstrated similar or significantly better predictive ability in predicting 30-day mortality and early recurrent hemorrhage rates in patients with gastrointestinal bleeding [6][7][8]. Following the study by Laursen S.B., several other studies have also reinforced the solid predictive value of the ABC score in predicting 30-day mortality in patients with upper gastrointestinal bleeding with an accurately predicted AUROC of approximately 0.85 [7,9,10]. However, there is currently a limitation of data available on the value of the ABC score in predicting healthcare facility mortality (typically within about a week) and early re-hemorrhage rates (within five days).…”

Section: Introductionmentioning

confidence: 79%

Predictive Significance of the ABC Score for Early Re-Hemorrhage and In-Hospital Mortality in High-Risk Variceal Bleeding among Cirrhotic Patients

Ky,

Trang,

Binh

2023

Diagnostics

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(1) Background: Upper gastrointestinal bleeding due to ruptured varices is a severe complication in patients with cirrhosis, with high rates of recurrent hemorrhage and in-hospital mortality. This study aimed to evaluate the value of the ABC score in predicting two events among 201 cirrhotic patients with high-risk variceal hemorrhage. (2) Methods: The ABC score was calculated and categorized into risk groups of patients, and the association between the ABC score and the rates of early hemorrhagic recurrence and clinic mortality were analyzed. (3) Results: Among 201 patients, 8.0% experienced early rebleeding within five days of admission, and 10.4% died in the hospital. Patients who experienced events had higher average ABC scores compared to those who did not experience these events (p < 0.001), especially in the high-risk group (with ABC score ≥ 8). The ABC score showed an excellent predictive value for in-hospital mortality with an AUROC of 0.804, with the optimal cutoff point being 8 points. Additionally, the ABC score demonstrated an acceptable predictive value for early rebleeding with an AUROC of 0.744, and the best cutoff point was 9 points. (4) Conclusions: The ABC score is closely associated with the rates of early re-hemorrhage and in-hospital mortality in cirrhotic patients with variceal bleeding. This scoring system has the potential for clinical application, aiding in early risk stratification for recurrent bleeding and mortality and allowing for more aggressive interventions in high-risk cases.

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“…This is because the AIMS65 score was designed to be used with high cutoff values to identify patients at high risk for death rather than those at low risk for safe discharge, and about 20% of high-risk patients may be classified as being at low risk ( 2 ). In this study, the data value for albumin was missing in more than 20% of the total population; for comparison, we replaced the Charlson Comorbidity Index (CCI) value with the albumin level according to severity; following the previous literature, we replaced patients with a CCI equal to or greater than 5 points with albumin below 30 g/L ( 33 ). In our study, the AUC of AIMS65 for predicting GIB mortality was 0.776 and 0.802 in the training and validation groups, respectively.…”

Section: Discussionmentioning

confidence: 99%

A nomogram to predict in-hospital mortality of gastrointestinal bleeding patients in the intensive care unit

Zhang,

Ni,

Zhang

et al. 2023

Front. Med.

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BackgroundGastrointestinal bleeding (GIB) is a common condition in clinical practice, and predictive models for patients with GIB have been developed. However, assessments of in-hospital mortality due to GIB in the intensive care unit (ICU), especially in critically ill patients, are still lacking. This study was designed to screen out independent predictive factors affecting in-hospital mortality and thus establish a predictive model for clinical use.MethodsThis retrospective study included 1,442 patients with GIB who had been admitted to the ICU. They were selected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) 1.0 database and divided into a training group and a validation group in a ratio of 7:3. The main outcome measure was in-hospital mortality. Least absolute shrinkage and section operator (LASSO) regression was used to screen out independent predictors and create a nomogram.ResultsLASSO regression picked out nine independent predictors: heart rate (HR), activated partial thromboplastin time (aPTT), acute physiology score III (APSIII), sequential organ failure assessment (SOFA), cerebrovascular disease, acute kidney injury (AKI), norepinephrine, vasopressin, and dopamine. Our model proved to have excellent predictive value with regard to in-hospital mortality (the area under the receiver operating characteristic curve was 0.906 and 0.881 in the training and validation groups, respectively), as well as a good outcome on a decision curve analysis to assess net benefit.ConclusionOur model effectively predicts in-hospital mortality in patients with GIB, indicating that it may prove to be a valuable tool in future clinical practice.

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Validation of the new ABC score for predicting 30-day mortality in gastrointestinal bleeding

Cited by 11 publications

References 17 publications

CHAMPS score in predicting mortality of patients with acute nonvariceal upper gastrointestinal bleeding

CHAMPS score in predicting mortality of patients with acute nonvariceal upper gastrointestinal bleeding

Predictive Significance of the ABC Score for Early Re-Hemorrhage and In-Hospital Mortality in High-Risk Variceal Bleeding among Cirrhotic Patients

A nomogram to predict in-hospital mortality of gastrointestinal bleeding patients in the intensive care unit

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