PDF(Pubmed)
Abstract：
UNASSIGNED: The Charlson Comorbidity Index ≥2, in-Hospital onset, Albumin <2.5 g/dL, altered Mental status, Eastern Cooperative Oncology Group Performance status ≥2, Steroid use (CHAMPS) score is a novel and promising prognostic tool. We present an initial external validation of the CHAMPS score for predicting mortality in acute nonvariceal upper gastrointestinal bleeding (NVUGIB) across multiple clinical outcomes.
UNASSIGNED: A prospective cohort study was conducted on adult patients with NVUGIB admitted to the Department of Gastroenterology between November 2022 and June 2023. The CHAMPS score performance in predicting in-hospital outcomes was evaluated by employing area under the receiver operating characteristic (AUROC) curves, followed by a comparative analysis with five pre-existing scores.
UNASSIGNED: A total of 140 patients were included in the study. The CHAMPS score showed its highest performance in predicting mortality rates (AUROC = 0.89), significantly outperforming the Glasgow-Blatchford Bleeding Score (GBS) as well as the Albumin level <3.0 mg/dL, International normalized ratio >1.5, altered Mental status, Systolic blood pressure ≤90 mmHg, and age >65 years (AIMS65) score (AUROC = 0.72 and 0.71, respectively; all p < 0.05). Subgroup analysis for bleeding-related and non-bleeding-related mortality further confirmed the robust predictive capability of the CHAMPS score (AUROC = 0.88 and 0.87, respectively). The CHAMPS score failed to predict rebleeding and intervention reliably, exhibiting AUROC values of 0.43 and 0.55, respectively. The optimal CHAMPS score cutoff value for predicting mortality was 3 points, achieving 100% sensitivity and 71.2% specificity. In the low-risk category defined by both CHAMPS and GBS scores, mortality and rebleeding rates were 0%. However, within the CHAMPS score-based low-risk group, 58.8% required intervention, contrasting with a 0% intervention rate for the GBS score-based low-risk group (GBS score ≤1).
UNASSIGNED: The CHAMPS score consistently demonstrated a robust predictive performance for mortality (AUROC > 0.8), facilitating the identification of high-risk patients requiring aggressive treatment and low-risk patients in need of localized treatment or safe discharge after successful bleeding control.
UNASSIGNED: A prospective cohort study was conducted on adult patients with NVUGIB admitted to the Department of Gastroenterology between November 2022 and June 2023. The CHAMPS score performance in predicting in-hospital outcomes was evaluated by employing area under the receiver operating characteristic (AUROC) curves, followed by a comparative analysis with five pre-existing scores.
UNASSIGNED: A total of 140 patients were included in the study. The CHAMPS score showed its highest performance in predicting mortality rates (AUROC = 0.89), significantly outperforming the Glasgow-Blatchford Bleeding Score (GBS) as well as the Albumin level <3.0 mg/dL, International normalized ratio >1.5, altered Mental status, Systolic blood pressure ≤90 mmHg, and age >65 years (AIMS65) score (AUROC = 0.72 and 0.71, respectively; all p < 0.05). Subgroup analysis for bleeding-related and non-bleeding-related mortality further confirmed the robust predictive capability of the CHAMPS score (AUROC = 0.88 and 0.87, respectively). The CHAMPS score failed to predict rebleeding and intervention reliably, exhibiting AUROC values of 0.43 and 0.55, respectively. The optimal CHAMPS score cutoff value for predicting mortality was 3 points, achieving 100% sensitivity and 71.2% specificity. In the low-risk category defined by both CHAMPS and GBS scores, mortality and rebleeding rates were 0%. However, within the CHAMPS score-based low-risk group, 58.8% required intervention, contrasting with a 0% intervention rate for the GBS score-based low-risk group (GBS score ≤1).
UNASSIGNED: The CHAMPS score consistently demonstrated a robust predictive performance for mortality (AUROC > 0.8), facilitating the identification of high-risk patients requiring aggressive treatment and low-risk patients in need of localized treatment or safe discharge after successful bleeding control.
摘要：
■Charlson合并症指数≥2，住院发病，白蛋白<2.5g/dL，精神状态改变,东部肿瘤协作组表现状态≥2，类固醇使用（CHAMPS）评分是一种新颖且有前途的预后工具。我们提出了CHAMPS评分的初步外部验证，用于预测多种临床结局的急性非静脉曲张性上消化道出血（NVUGIB）的死亡率。
■对2022年11月至2023年6月期间进入消化内科的NVUGIB成年患者进行了一项前瞻性队列研究。CHAMPS评分在预测住院结局方面的表现是通过使用接受者工作特征(AUROC)曲线下面积来评估的。接下来是五个预先存在的分数的比较分析。
■共有140名患者被纳入研究。CHAMPS评分在预测死亡率方面表现最高（AUROC=0.89），显着优于格拉斯哥-布拉特福德出血评分（GBS）以及白蛋白水平<3.0mg/dL，国际标准化比率>1.5，精神状态改变，收缩压≤90mmHg,年龄>65岁（AIMS65）评分（AUROC分别为0.72和0.71；所有p<0.05）。出血相关和非出血相关死亡率的亚组分析进一步证实了CHAMPS评分的稳健预测能力(AUROC分别为0.88和0.87)。CHAMPS评分未能可靠地预测再出血和干预，AUROC值分别为0.43和0.55。预测死亡率的最佳CHAMPS评分临界值为3分，达到100%的灵敏度和71.2%的特异性。在CHAMPS和GBS评分定义的低风险类别中，死亡率和再出血率为0%。然而,在基于CHAMPS评分的低风险组中，58.8%需要干预，与基于GBS评分的低风险组(GBS评分≤1)的0%干预率形成对比.
■CHAMPS评分始终显示出对死亡率的强大预测性能（AUROC>0.8），有助于识别需要积极治疗的高危患者和需要局部治疗或成功控制出血后安全出院的低危患者。
■对2022年11月至2023年6月期间进入消化内科的NVUGIB成年患者进行了一项前瞻性队列研究。CHAMPS评分在预测住院结局方面的表现是通过使用接受者工作特征(AUROC)曲线下面积来评估的。接下来是五个预先存在的分数的比较分析。
■共有140名患者被纳入研究。CHAMPS评分在预测死亡率方面表现最高（AUROC=0.89），显着优于格拉斯哥-布拉特福德出血评分（GBS）以及白蛋白水平<3.0mg/dL，国际标准化比率>1.5，精神状态改变，收缩压≤90mmHg,年龄>65岁（AIMS65）评分（AUROC分别为0.72和0.71；所有p<0.05）。出血相关和非出血相关死亡率的亚组分析进一步证实了CHAMPS评分的稳健预测能力(AUROC分别为0.88和0.87)。CHAMPS评分未能可靠地预测再出血和干预，AUROC值分别为0.43和0.55。预测死亡率的最佳CHAMPS评分临界值为3分，达到100%的灵敏度和71.2%的特异性。在CHAMPS和GBS评分定义的低风险类别中，死亡率和再出血率为0%。然而,在基于CHAMPS评分的低风险组中，58.8%需要干预，与基于GBS评分的低风险组(GBS评分≤1)的0%干预率形成对比.
■CHAMPS评分始终显示出对死亡率的强大预测性能（AUROC>0.8），有助于识别需要积极治疗的高危患者和需要局部治疗或成功控制出血后安全出院的低危患者。
