Key result
A new risk score model accurately predicted gastrointestinal bleeding in cardiology inpatients (validation AUROC 0.841; 95% CI, 0.807-0.874), outperforming HAS-BLED and CRUSADE scores.
Why the study?
Although early use of a risk stratification score in gastrointestinal bleeding is recommended, no risk score existed for patients admitted to the cardiology department.
Does a newly developed risk score model accurately predict gastrointestinal bleeding in patients admitted to the cardiology department compared to existing scores?
Case-Control (n=4,864)
Does a newly developed risk score model accurately predict gastrointestinal bleeding in patients admitted to the cardiology department compared to existing scores?
Effect estimate: AUROC 0.841 (95% CI 0.807-0.874)
A newly developed, cardiology-specific risk score accurately predicts in-hospital gastrointestinal bleeding and outperforms established scores like HAS-BLED and CRUSADE.
New GIB risk score for cardiology inpatients may aid stratification; leaves open its validity without prospective validation.
OBJECTIVE: Although the early use of a risk stratification score in gastrointestinal bleeding (GIB) is recommended, so far there has been no risk score for GIB in patients admitted to the cardiology department. To describe the risk factors of GIB and develop a new risk score model in patients admitted to the cardiology department. METHODS: A total of 633 inpatients with GIB from January 2014 to December 2018 were recruited, 4,231 inpatients with non-GIB were recruited as the control group. Multivariate logistic regression was used to describe the risk factors of GIB. A new risk score model was developed in the derivation cohort. Accuracy to predict GIB was assessed by the area under the receiver operating characteristic (AUROC) curve in the validation cohort. RESULTS: Male, coronary heart disease, hypertension, stroke, systolic blood pressure, hematocrit, plasma albumin, and alanine aminotransferase (ALT) were associated with GIB. The model had a high predictive accuracy (AUROC 0.816 and 95% CI, 0.792-0.839), which was supported by the validation cohort (AUROC 0.841 and 95% CI, 0.807~0.874). Besides, the prediction of the model was better than HAS-BLED score (AUROC 0.557; 95% CI, 0.513~0.602) and CRUSADE score (AUROC 0.791; 95%CI, 0.757~0.825), respectively. Among the inpatients with a score of 0-3, 4-7, and ≥8 points, the incidence of GIB, the proportion of inpatients requiring suspended red blood cells transfusion, length of stay, and in-hospital mortality all increased gradually (P< 0.001). CONCLUSIONS: Male, coronary heart disease, hypertension, stroke, systolic blood pressure, hematocrit, plasma albumin, and ALT are associated with GIB. The new risk score model is an accurate risk score that predicts GIB in patients admitted to the cardiology department.
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Zhang et al. (2020) conducted a case-control in Gastrointestinal bleeding in cardiology patients (n=4,864). New risk score model vs. HAS-BLED and CRUSADE scores was evaluated on Accuracy to predict gastrointestinal bleeding (validation cohort) (AUROC 0.841, 95% CI 0.807-0.874). A new risk score model accurately predicted gastrointestinal bleeding in cardiology inpatients (validation AUROC 0.841; 95% CI, 0.807-0.874), outperforming HAS-BLED and CRUSADE scores.
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