Expert Review of Gastroenterology & Hepatology最新文献_第8页

Diagnosis and management of pancreatic insufficiency in patients with gastrectomy due to cancer or gastric ulcers: a virtual roundtable expert discussion. 癌症或胃溃疡导致胃切除术患者胰腺功能不全的诊断和管理：虚拟圆桌专家讨论。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-01 Epub Date: 2024-01-17 DOI: 10.1080/17474124.2023.2296762

Daniel Croagh, Christoph W Michalski, Mark I van Berge Henegouwen, Sergio Alfieri

{"title":"Diagnosis and management of pancreatic insufficiency in patients with gastrectomy due to cancer or gastric ulcers: a virtual roundtable expert discussion.","authors":"Daniel Croagh, Christoph W Michalski, Mark I van Berge Henegouwen, Sergio Alfieri","doi":"10.1080/17474124.2023.2296762","DOIUrl":"10.1080/17474124.2023.2296762","url":null,"abstract":"Introduction: Pancreatic exocrine insufficiency (PEI) is common after gastric resection for cancer or ulcers but is under-recognized and undertreated. Although pancreatic enzyme replacement therapy (PERT) is the mainstay of PEI management, robust evidence supporting its use after gastric surgery is limited.Areas covered: In the absence of guideline recommendations specific for patients with pancreatic insufficiency after gastrectomy, a panel of experts from different geographical regions convened in a virtual meeting to discuss their approach to patient management.Expert opinion: Pancreatic insufficiency after gastrointestinal surgery is not a simple post-surgical complication as several factors contribute to its development. Although the pancreas is unimpaired after gastrectomy, it cannot function normally in the altered environment. Pancreatic insufficiency can be challenging to diagnose in gastrectomy patients due to nonspecific symptoms and the absence of a simple diagnostic test. Fecal elastase appears to be the default test, although it is not sufficiently sensitive nor reliable for diagnosing or monitoring PEI. Patients with maldigestion symptoms after gastrectomy are treated pragmatically: those with clinical suspicion of pancreatic insufficiency receive a trial of PERT and are monitored for symptom improvement. There is a clear need for high-quality evidence from clinical trials to guide the management of this patient population.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1313-1319"},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138802135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Noninvasive electrical neuromodulation for gastrointestinal motility disorders. 胃肠运动障碍的无创神经电调节。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-01 Epub Date: 2024-01-17 DOI: 10.1080/17474124.2023.2288156

Jieyun Yin, Jiande Dz Chen

{"title":"Noninvasive electrical neuromodulation for gastrointestinal motility disorders.","authors":"Jieyun Yin, Jiande Dz Chen","doi":"10.1080/17474124.2023.2288156","DOIUrl":"10.1080/17474124.2023.2288156","url":null,"abstract":"Introduction: Gastrointestinal motility disorders are highly prevalent without satisfactory treatment. noninvasive electrical neuromodulation is an emerging therapy for treating various gastrointestinal motility disorders.Areas covered: In this review, several emerging noninvasive neuromodulation methods are introduced, including transcutaneous auricular vagal nerve stimulation, percutaneous auricular vagal nerve stimulation, transcutaneous cervical vagal nerve stimulation, transcutaneous electrical acustimulation, transabdominal interference stimulation, tibial nerve stimulation, and translumbosacral neuromodulation therapy. Their clinical applications in the most common gastrointestinal motility are discussed, including gastroesophageal reflux disease, functional dyspepsia, gastroparesis, functional constipation, irritable bowel syndrome, and fecal incontinence. PubMed database was searched from 1995 to June 2023 for relevant articles in English.Expert opinion: Noninvasive neuromodulation is effective and safe in improving both gastrointestinal symptoms and dysmotility; it can be used when pharmacotherapy is ineffective. Future directions include refining the methodology, improving device development and understanding mechanisms of action.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1221-1232"},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10842705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138451321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

To STRIDE or not to STRIDE: a critique of "treat to target" in Crohn´s disease. STRIDE与否：对克罗恩病 "靶向治疗 "的批判。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-01 Epub Date: 2024-01-17 DOI: 10.1080/17474124.2023.2296564

Klaus R Herrlinger, Eduard F Stange

{"title":"To STRIDE or not to STRIDE: a critique of \"treat to target\" in Crohn´s disease.","authors":"Klaus R Herrlinger, Eduard F Stange","doi":"10.1080/17474124.2023.2296564","DOIUrl":"10.1080/17474124.2023.2296564","url":null,"abstract":"Introduction: The STRIDE consensus suggested to focus on mucosal healing, based on biomarkers and endoscopy, in addition to clinical endpoints as treatment target. This narrative review provides a critique of this concept in Crohn´s disease.Areas covered: We analyze and discuss the limitations of endpoints as targets, their currently limited achievability, and the controversial evidence relating to 'treat to target.' The relevant publications in Pubmed were identified in a literature review with the key word 'Crohn´s disease.'Expert opinion: All targets and endpoints have their limitations, and, even if reached, not all have unequivocally been shown to improve prognosis. The major deficiency of STRIDE is not only the lack of validation and agreement upon endpoints but little evidence of their achievability in a sizable proportion of patients by dose or timing adjustments or switching the medication. Above all, the concept should be based on clear evidence that patients indeed benefit from appropriate escalation of treatment and relevant controlled studies in this regard have been controversial. Until the STRIDE approach is proven to be superior to standard treatment focusing on clinical well-being, the field should remain reluctant and expect more convincing evidence before new targets are approved.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1205-1219"},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138829123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nosocomial spontaneous bacterial peritonitis is associated with high mortality - a systematic review and meta-analysis. 医院源性自发性细菌性腹膜炎与高死亡率相关——一项系统综述和荟萃分析。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-01 Epub Date: 2024-01-17 DOI: 10.1080/17474124.2023.2284825

Mubeen Khan Mohammed Abdul, Karim T Osman, Joseph M Cappuccio, Carol Spencer, Sanjaya K Satapathy

{"title":"Nosocomial spontaneous bacterial peritonitis is associated with high mortality - a systematic review and meta-analysis.","authors":"Mubeen Khan Mohammed Abdul, Karim T Osman, Joseph M Cappuccio, Carol Spencer, Sanjaya K Satapathy","doi":"10.1080/17474124.2023.2284825","DOIUrl":"10.1080/17474124.2023.2284825","url":null,"abstract":"Introduction: It is unclear if Nosocomial Spontaneous Bacteria Peritonitis (NSBP) is associated with higher mortality compared with community acquired spontaneous bacterial peritonitis.Methods: Database search from inception to May 2022 was conducted. The databases included MEDLINE, EMBASE, Cochrane registry of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus. Inclusion criteria were as follows: adult patients, age >18 years, with a diagnosis of NSBP. Pooled estimates of mortality were calculated following the restricted maximum likelihood method. The mortality rate between NSBP and CA-SBP was reported as odds ratio (OR) and 95% confidence interval (CI). Data synthesis was obtained using random effects meta-analysis. Heterogeneity was reported as I2.Results: A total of 482 unique titles were screened. Twenty-two articles were included. A total of 2,145 patients with NSBP were included. Patients were followed for a median of 90 days. The pooled mortality rate of NSBP was 52.51% (95% CI 42.77-62.06%; I2 83.72%). Seven studies compared the mortality outcome of patients with NSBP and CA-SBP. NSBP was significantly associated with a higher rate of mortality (OR 2.78, 95% CI 1.87-4.11; I2 36.00%).Conclusion: NSBP was associated with higher mortality rate compared to CA-SBP, which could be due to a higher rate of resistance organisms.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1333-1339"},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138046685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating the molecular and genetic mechanisms underlying gut motility disorders. 评估肠道运动紊乱的分子和遗传机制。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-01 Epub Date: 2024-01-17 DOI: 10.1080/17474124.2023.2296558

Atchariya Chanpong, Maria M Alves, Elena Bonora, Roberto De Giorgio, Nikhil Thapar

{"title":"Evaluating the molecular and genetic mechanisms underlying gut motility disorders.","authors":"Atchariya Chanpong, Maria M Alves, Elena Bonora, Roberto De Giorgio, Nikhil Thapar","doi":"10.1080/17474124.2023.2296558","DOIUrl":"10.1080/17474124.2023.2296558","url":null,"abstract":"Introduction: Gastrointestinal (GI) motility disorders comprise a wide range of different diseases affecting the structural or functional integrity of the GI neuromusculature. Their clinical presentation and burden of disease depends on the predominant location and extent of gut involvement as well as the component of the gut neuromusculature affected.Areas covered: A comprehensive literature review was conducted using the PubMed and Medline databases to identify articles related to GI motility and functional disorders, published between 2016 and 2023. In this article, we highlight the current knowledge of molecular and genetic mechanisms underlying GI dysmotility, including disorders of gut-brain interaction, which involve both GI motor and sensory disturbance.Expert opinion: Although the pathophysiology and molecular mechanisms underlying many such disorders remain unclear, recent advances in the assessment of intestinal tissue samples, genetic testing with the application of 'omics' technologies and the use of animal models will provide better insights into disease pathogenesis as well as opportunities to improve therapy.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1301-1312"},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138829121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preoperative endoscopic ultrasound-guided biliary drainage for primary drainage in obstructive jaundice. 术前内镜超声引导胆道引流术，用于梗阻性黄疸的初次引流。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-01 Epub Date: 2024-01-17 DOI: 10.1080/17474124.2023.2293813

Shuntaro Mukai, Takao Itoi

{"title":"Preoperative endoscopic ultrasound-guided biliary drainage for primary drainage in obstructive jaundice.","authors":"Shuntaro Mukai, Takao Itoi","doi":"10.1080/17474124.2023.2293813","DOIUrl":"10.1080/17474124.2023.2293813","url":null,"abstract":"Introduction: Endoscopic transpapillary approach by endoscopic retrograde cholangiopancreatography (ERCP) is the established technique for preoperative biliary drainage (PBD). Recently, endoscopic ultrasound-guided biliary drainage (EUS-BD) has been reported to be a useful alternative technique after ERCP fail. However, the optimal strategy remain controversial.Area covered: This review summarizes the literature on EUS-BD techniques for PBD with a literature search using PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials database between 2000 and 2023 using keywords for 'preoperative biliary drainage' and all types of EUS-BD techniques.Expert opinion: As there is no consensus on the optimal EUS-BD technique for PBD, selection of the EUS-BD approach depends on the patient's condition, the biliary obstruction site, the anastomosis after surgical intervention, and the preference of the endoscopist. However, we consider that EUS-HGS using a dedicated plastic stent may have some advantages in the adverse impact of surgical procedure because the location where the fistula is created by EUS-HGS is away from the site of the surgical procedure. Although there remain many issues that require further investigation, EUS-BD can be a feasible and safe alternative method of PBD for malignant biliary obstruction after ERCP fail.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1197-1204"},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138829122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Securing the diagnosis of HRS-AKI: implications for current therapies. 确保rs - aki的诊断:对当前治疗的影响。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-01 Epub Date: 2024-01-17 DOI: 10.1080/17474124.2023.2284189

Arpan Mohanty, Andrés Cárdenas

{"title":"Securing the diagnosis of HRS-AKI: implications for current therapies.","authors":"Arpan Mohanty, Andrés Cárdenas","doi":"10.1080/17474124.2023.2284189","DOIUrl":"10.1080/17474124.2023.2284189","url":null,"abstract":"Introduction: Hepatorenal syndrome (HRS)-acute kidney injury (HRS-AKI) is a specific type of kidney injury seen in patients with cirrhosis and ascites and is associated with high mortality and morbidity. It is characterized by rapid deterioration of renal function due to reduced renal blood flow secondary to portal hypertensive splanchnic and systemic vasodilation. Early diagnosis and treatment of HRS-AKI are associated with greater likelihood of improvement in renal function, lower need for dialysis, and better post-transplant outcomes.Areas covered: This review discusses the diagnostic criteria for HRS-AKI, which has undergone several key changes over the last decade, with an aim to secure an early diagnosis and aid swift treatment initiation. Additionally, this review outlines the current treatment paradigms for HRS-AKI.Expert opinion: In the last 20 years, there have been several advances in understanding the pathophysiology and natural course of HRS-AKI. These have led to critical changes in its definition and diagnostic algorithm. However, prognosis of HRS-AKI remains dismal with no significant improvement in HRS-AKI reversal or HRS-related mortality over this time. We discuss several gaps in the current understanding and management of HRS-AKI that will benefit from further research.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1233-1239"},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138046686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A systematic review and meta-analysis on GERD after OAGB: rate, treatments, and success. 关于 OAGB 术后胃食管反流病的系统回顾和荟萃分析：发病率、治疗方法和成功率。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-01 Epub Date: 2024-01-17 DOI: 10.1080/17474124.2023.2296992

Amir Hossein Davarpanah Jazi, Shahab Shahabi, Erfan Sheikhbahaei, Salvatore Tolone, Mehdi El Skalli, Ali Kabir, Rohollah Valizadeh, Mohammad Kermansaravi

{"title":"A systematic review and meta-analysis on GERD after OAGB: rate, treatments, and success.","authors":"Amir Hossein Davarpanah Jazi, Shahab Shahabi, Erfan Sheikhbahaei, Salvatore Tolone, Mehdi El Skalli, Ali Kabir, Rohollah Valizadeh, Mohammad Kermansaravi","doi":"10.1080/17474124.2023.2296992","DOIUrl":"10.1080/17474124.2023.2296992","url":null,"abstract":"Introduction: This review aims to investigate the gastroesophageal reflux disease (GERD) as one of the important concerns for both surgeons and patients after one anastomosis gastric bypass (OAGB).Method: PubMed, Scopus, Embase, Web of Science, and Cochrane were reviewed by the end of the 2021 with keywords relating to GERD, OAGB, and their equivalents. Data regarding OAGB, number of patients with GERD, treatment for GERD, endoscopy findings, the interval between GERD and OAGB were retrieved by two independent investigators. The primary effect/effect size measure was prevalence.Results: 40 studies examining 17,299 patients were included revealing that 2% of patients experience GERD following OAGB. Reflux after revisional OAGB is six times higher than primary OAGB. Despite being unclear, medical and surgical treatments for GERD after OAGB were used in 60% and 41% of patients with estimated success rate of 85% and 100%, respectively.Conclusion: Based on how GERD was identified after OAGB, its rate ranged from 0 to 55%; the pooled rate of 2% is near to Roux-en-Y gastric bypass. GERD symptoms can be mild to be tolerated without medical treatment, moderate that respond to acid-reducing agents, or severe enough that are categorized as interactable and would need a surgical intervention.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1321-1332"},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139039714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Imaging in pediatric disorders of the gut-brain interactions: current best practice and future directions. 儿童脑肠相互作用疾病的影像学:当前最佳实践和未来方向。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-12-01 Epub Date: 2024-01-17 DOI: 10.1080/17474124.2023.2288164

Shaman Rajindrajith, Wathsala Hathagoda, Eranga Ganewatte, Niranga Manjuri Devanarayana, Nikhil Thapar, Marc Benninga

{"title":"Imaging in pediatric disorders of the gut-brain interactions: current best practice and future directions.","authors":"Shaman Rajindrajith, Wathsala Hathagoda, Eranga Ganewatte, Niranga Manjuri Devanarayana, Nikhil Thapar, Marc Benninga","doi":"10.1080/17474124.2023.2288164","DOIUrl":"10.1080/17474124.2023.2288164","url":null,"abstract":"Introduction: Disorders of Gut-Brain Interactions (DGBI) are a common clinical problem in children and pose significant challenges to the attending pediatrician. Radiological investigations are commonly ordered to evaluate these children.Area covered: This review focuses on the current best practice of using radiological investigations in DGBIs and how novel radiological investigations could revolutionize the assessment and therapeutic approach of DGBI in children.Expert opinion: We believe imaging in DGBI is still in its early stages, but it has the potential to revolutionize how we diagnose and treat children with DGBI. As the understanding of the gut-brain axis continues to grow, we can expect to see the disappearance of conventional imaging techniques and the emergence of more sophisticated imaging techniques with less radiation exposure in the future which provide more clinically meaningful information regarding the gut-brain axis and its influence on intestinal function. Some of the novel imaging modalities will be able to broaden our horizon of understanding DGBI in children providing more useful therapeutic options to minimize their suffering.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1255-1266"},"PeriodicalIF":3.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138298850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Strengths and limitations of risk stratification tools for patients with upper gastrointestinal bleeding: a narrative review. 上消化道出血患者风险分层工具的优势和局限性：叙述性综述。

IF 3.9 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2023-07-01 Epub Date: 2023-07-31 DOI: 10.1080/17474124.2023.2242252

Ali A Alali, Antoine Boustany, Myriam Martel, Alan N Barkun

{"title":"Strengths and limitations of risk stratification tools for patients with upper gastrointestinal bleeding: a narrative review.","authors":"Ali A Alali, Antoine Boustany, Myriam Martel, Alan N Barkun","doi":"10.1080/17474124.2023.2242252","DOIUrl":"10.1080/17474124.2023.2242252","url":null,"abstract":"Introduction: Despite advances in the management of patients with upper gastrointestinal bleeding (UGIB), associated morbidity and mortality remain significant. Most patients, however, will experience favorable outcomes without a need for hospital-based interventions. Risk assessment scores may assist in such early risk-stratification. These scales may optimize identification of low-risk patients, resulting in better resource utilization, including a reduced need for early endoscopy and fewer hospital admissions. The aim of this article is to provide an updated detailed review of risk assessment scores in UGIB.Area covered: A literature review identified past and currently available pre-endoscopic risk assessment scores for UGIB, with a focus on low-risk prediction. Strengths and weaknesses of the different scales are discussed as well as their impact on clinical decision-making.Expert opinion: The current evidence supports using the Glasgow Blatchford Score as it is the most accurate tool available when attempting to identify low-risk patients who can be safely managed on an outpatient basis. Currently, no risk assessment tool appears accurate enough in confidently classifying patients as high risk. Future research should utilize more standardized methodologies, while favoring interventional trial designs to better characterize the clinical impact attributable to the use of such risk stratification schemes.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":"17 8","pages":"795-803"},"PeriodicalIF":3.9,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1