Sengupta and Tapper reported a clinical prediction tool for mortality following acute lower gastrointestinal bleeding. This can help to identify a patient who may require more aggressive management. The authors are from the University of Chicago and the University of Michigan.
Patient selection: adult with lower GI bleeding
Outcome: 30-day mortality
Parameters:
(1) age in years
(2) dementia
(3) chronic kidney disease
(4) metastatic cancer
(5) systemic anticoagulant use
(6) chronic pulmonary disease
(7) admission hematocrit
(8) admission serum albumin
Parameter
Finding
Points
age
< 30 years
-2
30 to 39
-1
40 to 49
0
50 to 59
1
60 to 69
2
70 to 79
3
80 to 90
4
> 90
5
dementia
no
0
yes
5
chronic kidney disease
no
0
yes
2
metastatic cancer
no
0
yes
5
anticoagulation
no
0
yes
1
chronic pulmonary disease
no
0
yes
2
admission hematocrit
< 20
3
20 to 29
1
30 to 39
0
>= 40
-1
admission albumin
< 2.0
13
2.0 to 2.9
7
3.0 to 3.9
0
>= 4.0
-7
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: -10
• maximum score: 36
• The higher the score the greater the 30-day mortality.
Quartile
30-Day Mortality
<= 1
4%
2 to 4
5-7%
5 to 8
9-10%
>= 9
24-26%
Performance:
• The area under the ROC curve ranged in variosu groups fom0.72 to 0.81.
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