A clinical predictive model for risk stratification of patients with severe acute lower gastrointestinal bleeding

Autor:	Jayne Chiang, Andre Seah, Nan Liu, Manraj Singh, Sachin Mathur, Ronnie Mathew
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	Tachycardia medicine.medical_specialty Lower gastrointestinal bleeding RD1-811 Haemorrhagic Logistic regression Risk Assessment Haematochezia Acute care Positive predicative value medicine Humans Retrospective Studies business.industry RC86-88.9 Retrospective cohort study Shock Medical emergencies. Critical care. Intensive care. First aid medicine.disease Triage Per-rectal bleed Predictive model Area Under Curve Emergency medicine Risk stratification Acute Disease Emergency Medicine Surgery medicine.symptom business Gastrointestinal Hemorrhage Research Article
Zdroj:	World Journal of Emergency Surgery, Vol 16, Iss 1, Pp 1-10 (2021) World Journal of Emergency Surgery : WJES
ISSN:	1749-7922
Popis:	Background Lower gastrointestinal bleeding (LGIB) is a common presentation of surgical admissions, imposing a significant burden on healthcare costs and resources. There is a paucity of standardised clinical predictive tools available for the initial assessment and risk stratification of patients with LGIB. We propose a simple clinical scoring model to prognosticate patients at risk of severe LGIB and an algorithm to guide management of such patients. Methods A retrospective cohort study was conducted, identifying consecutive patients admitted to our institution for LGIB over a 1-year period. Baseline demographics, clinical parameters at initial presentation and treatment interventions were recorded. Multivariate logistic regression was performed to identify factors predictive of severe LGIB. A clinical management algorithm was developed to discriminate between patients requiring admission, and to guide endoscopic, angiographic and/or surgical intervention. Results 226/649 (34.8%) patients had severe LGIB. Six variables were entered into a clinical predictive model for risk stratification of LGIB: Tachycardia (HR ≥ 100), hypotension (SBP Conclusion Early diagnosis and management of severe LGIB remains a challenge for the acute care surgeon. The predictive model described comprises objective clinical parameters routinely obtained at initial triage to guide risk stratification, disposition and inpatient management of patients.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6ebc7f0c4e0af38b6e84927942099aaf https://doaj.org/article/b083bee09789431b9f5fb0d0acc7d17a Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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