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MH-STRALP:A scoring system for prognostication in patients with upper gastrointestinal bleeding

World Journal of Gastrointestinal Surgery 2024年第3期16卷 790-806页

作者： Jun-Nan Hu Fei Xu Ya-Rong Hao Chun-Yan Sun Kai-Ming Wu Yong Lin Lan Zhong Xin Zeng Department of Gastroenterology Shanghai East HospitalTongji University School of MedicineShanghai 200120China Department of Gastroenterology Shanghai Changzheng HospitalNavy Military Medical UniversityShanghai 200003China

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.

关键词： Upper gastrointestinal bleeding Prognosis prediction Retrospective study Nomogram post-endoscopic model Pre-endoscopic model

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