预测肝硬化患者首次上消化道出血的风险分层评分

IF 3.4 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
Nasser Mousa , Sherif Elbaz , Alaa Elmetwalli , Marwa Mansour , Mostafa Abdelsalam , Mohammed Abdelaziz , Manal Hashem , Ola El-Emam , Niveen El-wakeel , Ayman Elgamal , Mohamed Wahba , Mohamed Selim , Muhammad Diasty , Wesam Elderiny , Adel El-Assmy , Eman Abdelkader
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引用次数: 0

摘要

背景与目的虽然内窥镜检查是诊断食管静脉曲张(EV)的标准方法,但它仅在发达国家可用。本研究旨在确定肝硬化患者初始静脉曲张出血(VB)发生的预测因素,并建立一个预测VB的评分系统。方法本研究分析了236例首次上消化道出血(UGIB)发作的肝硬化患者。采用logistic回归模型识别VB的独立危险因素并建立评分系统。我们使用受试者工作特征曲线下面积(AUC-ROC)评估评分系统的预测能力。结果本组154例患者出血源为EV。以下被确定为首次VB发作的独立危险因素:年龄超过60岁,糖尿病(DM),无缺血性心脏病,血小板低于130,000/uL,白蛋白2.9 g/dL,胆红素水平1.4 mg/dL, Child-Pugh评分b。通过对每个危险因素进行评分并将总分相加(最高7分)得出评分。这个分数被分为三个风险组:低风险<;3分;中级风险3-4分;高危≥5分。采用AUC-ROC分析评定疗效评分。低危组和高危组敏感性高,特异度低;中危组敏感性和特异度平衡。结论我们的评分是一种有价值的无创预测VB首次发作的工具。它有助于确定内窥镜检查的紧迫性和积极的管理策略的需要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Risk Stratification Score for Predicting First Episode of Upper Gastrointestinal Bleeding in Patients With Cirrhosis

Background and Aims

Although endoscopy is the standard method for diagnosing esophageal varices (EV), it is only available in developed countries. This study aims to identify predictors of the initial variceal bleeding (VB) occurrence and to develop a scoring system to predict the VB in patients with cirrhosis.

Methods

This study analyzed 236 patients with cirrhosis who experienced their first upper gastrointestinal bleeding (UGIB) episode. A logistic regression model was used to identify independent risk factors for VB and create a scoring system. We assessed the predictive ability of the scoring system using the area under the receiver operating characteristic curve (AUC-ROC).

Results

Of the included patients, 154 had EV as the bleeding source. The following were identified as independent risk factors for the first VB episode: age over 60 years, diabetes mellitus (DM), absence of ischemic heart disease, platelets below 130,000/uL, albumin >2.9 g/dL, bilirubin level >1.4 mg/dL, and Child-Pugh score B. A score was developed by assigning points to each risk factor and summing the total score (maximum 7 points). This score was categorized into three risk groups: low risk <3 points; intermediate risk 3–4 points; and high risk ≥5 points. The performance score was assessed using AUC-ROC analysis. Both the low- and high-risk categories had high sensitivity but low specificity, while the intermediate-risk group had balanced sensitivity and specificity.

Conclusion

Our score is a valuable noninvasive tool for predicting the first VB episode. It helps determine the urgency of endoscopy and the need for aggressive management strategies.
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来源期刊
Archives of Medical Research
Archives of Medical Research 医学-医学:研究与实验
CiteScore
12.50
自引率
0.00%
发文量
84
审稿时长
28 days
期刊介绍: Archives of Medical Research serves as a platform for publishing original peer-reviewed medical research, aiming to bridge gaps created by medical specialization. The journal covers three main categories - biomedical, clinical, and epidemiological contributions, along with review articles and preliminary communications. With an international scope, it presents the study of diseases from diverse perspectives, offering the medical community original investigations ranging from molecular biology to clinical epidemiology in a single publication.
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