奥克兰急性下消化道出血患者安全出院评分的有效性:验证研究

Nurhayat Başkaya, Rohat Ak, Rümeysa İnci, Burak Alper Mollaoğlu, Melis Rezai, Muhammet Zahit Tursun, A. U. Seyhan
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引用次数: 0

摘要

背景:急性下消化道出血(LGIB)给急诊医学带来了巨大挑战,需要有效的风险分层和管理工具。为预测 LGIB 患者的安全出院和死亡率而开发的奥克兰评分具有潜在的实用性,但需要在不同的临床环境中进行验证。材料与方法:这项回顾性研究分析了 2021 年 1 月 1 日至 2022 年 1 月 1 日期间在 Kartal Dr. Lütfi Kırdar 市医院就诊的 365 名 LGIB 患者。我们评估了奥克兰评分在预测安全出院和死亡率方面的有效性,通过统计分析确定了评分的预测准确性并确定了临界阈值。研究结果在研究人群中,60.27%的人出现血崩,年龄和性别分布各不相同。42.47%的病例进行了侵入性手术,51.78%的病例患有心血管疾病。与住院患者(21.90 分)相比,出院患者的平均奥克兰评分(18.22 分)明显较低,出院临界值为 16 分。在预测出院结果方面,奥克兰评分的灵敏度为 77%,特异度为 52.3%,死亡率风险增加的临界值为 24,证明了其预测价值。结论奥克兰评分能有效预测土耳其医院中 LGIB 患者的安全出院和死亡率。它为临床决策定义了临界阈值,是急诊科优化患者管理和资源分配的重要工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of the Oakland Score for Safe Discharge of Patients with Acute Lower Gastrointestinal Bleeding: A Validation Study
Background: Acute lower gastrointestinal bleeding (LGIB) presents a significant challenge in emergency medicine, necessitating tools for effective risk stratification and management. The Oakland Score, developed to predict safe discharge and mortality in LGIB patients, offers potential utility but requires validation in diverse clinical settings. Material and Methods: This retrospective study analyzed 365 patients presenting with LGIB at Kartal Dr. Lütfi Kırdar City Hospital between January 1, 2021, and January 1, 2022. We evaluated the Oakland Score's effectiveness in predicting safe discharge and mortality, employing statistical analyses to determine the score's predictive accuracy and identify critical thresholds. Results: Among the study population, 60.27% presented with hematochezia, with a diverse age and gender distribution. Invasive procedures were performed in 42.47% of cases, and cardiovascular diseases were prevalent in 51.78%. The average Oakland Score was significantly lower for discharged patients (18.22) compared to those hospitalized (21.90), with a critical discharge threshold identified at a score of 16. The Oakland Score also demonstrated a sensitivity of 77% and specificity of 52.3% for predicting discharge outcomes, and a critical value of 24 for increased mortality risk, substantiating its predictive value. Conclusions: The Oakland Score effectively predicts safe discharge and mortality among LGIB patients in a Turkish hospital setting. With defined critical thresholds for clinical decision-making, it stands as a valuable tool for optimizing patient management and resource allocation in emergency departments.
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