MH-STRALP:A scoring system for prognostication in patients with upper gastrointestinal bleeding
作者机构：Department of GastroenterologyShanghai East HospitalTongji University School of MedicineShanghai 200120China Department of GastroenterologyShanghai Changzheng HospitalNavy Military Medical UniversityShanghai 200003China
出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)
年 卷 期：2024年第16卷第3期
页 面：790-806页
核心收录：
学科分类：100218[医学-急诊医学] 1002[医学-临床医学] 1010[医学-医学技术（可授医学、理学学位）] 100214[医学-肿瘤学] 10[医学]
基 金：Supported by Key Disciplines Group Construction Project of Shanghai Pudong New Area Health Commission,No.PWZxq2022-06 Medical discipline Construction Project of Pudong Health Committee of Shanghai,No.PWYgf2021-02 Joint Tackling Project of Pudong Health Committee of Shanghai,No.PW2022D08 the Medical Innovation Research Project of the Shanghai Science and Technology Commission,No.22Y11908400
主 题：Upper gastrointestinal bleeding Prognosis prediction Retrospective study Nomogram Post-endoscopic model Pre-endoscopic model
摘 要：BACKGROUND Upper gastrointestinal bleeding(UGIB)is a common medical emergency and early assessment of its outcomes is vital for treatment *** To develop a new scoring system to predict its *** In this retrospective study,692 patients with UGIB were enrolled from two cen-ters and divided into a training(n=591)and a validation cohort(n=101).The clinical data were collected to develop new prognostic prediction *** en-dpoint was compound outcome defined as(1)demand for emergency surgery or vascular intervention,(2)being transferred to the intensive care unit,or(3)death during *** models’predictive ability was compared with previously esta-blished scores by receiver operating characteristic(ROC)*** Totally 22.2%(131/591)patients in the training cohort and 22.8%(23/101)in the validation cohort presented poor *** on the stepwise-forward Lo-gistic regression analysis,eight predictors were integrated to determine a new post-endoscopic prognostic scoring system(MH-STRALP);a nomogram was de-termined to present the *** with the previous scores(GBS,Rock-all,ABC,AIMS65,and PNED score),MH-STRALP showed the best prognostic prediction ability with area under the ROC curves(AUROCs)of 0.899 and 0.826 in the training and validation cohorts,*** to the calibration cur-ve,decision curve analysis,and internal cross-validation,the nomogram showed good calibration ability and net clinical benefit in both *** removing the endoscopic indicators,the pre-endoscopic model(pre-MH-STRALP score)was ***,the pre-MHSTRALP score showed better predictive value(AUROCs of 0.868 and 0.767 in the training and validation cohorts,respectively)than the other pre-endoscopic *** The MH-STRALP score and pre-MH-STRALP score are simple,convenient,and accurate tools for prognosis prediction of UGIB,and may be applied for early decision on its management strategies.
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