Fujita et al reported the LONG-HOSP score for predicting the length of stay for a patient with acute lower gastrointestinal bleeding. The authors are from multiple institutions in Japan.
LONG-HOSP is an acronym loosely based on the predictive factors.
Patient selection: acute lower gastrointestinal bleeding
Parameters:
(1) body mass index (BMI) in kg per square meter
(2) hemoglobin in g/dL
(3) albumin in g/dL
(4) BUN in mg/dL
(5) CRP in mg/dL
(6) age in years
(7) alcohol
(8) NSAID use (including low dose aspirin)
(9) number of hospital beds
(10) heart rate in beats per minute
(11) oral antithrombotic agent use
(12) abdominal pain
(13) diarrhea
(14) concomitant tarry stool
(15) systolic blood pressure in mm Hg
(16) ECOG performance status
(17) malignancy
(18) inflammatory bowel disease
|
Parameter |
Finding |
Points |
|
BMI |
>= 18.5 kg per sq m |
0 |
|
|
< 18.5 kg per sq m |
2 |
|
hemoglobin |
>= 13 g/dL |
0 |
|
|
11 to 12.9 g/dL |
2 |
|
|
8 to 10.8 g/dL |
4 |
|
|
7 to 8.9 g/dL |
5 |
|
|
< 7 g/dL |
6 |
|
albumin |
>= 3.5 g/dL |
0 |
|
|
3.0 to 3.4 g/dL |
3 |
|
|
2.5 to 2.9 g/dL |
5 |
|
|
< 2.5 g/dL |
10 |
|
BUN |
< 20 mg/dL |
0 |
|
|
20 to 44.9 mg/dL |
1 |
|
|
>= 45 mg/dL |
3 |
|
CRP |
< 0.5 mg/dL |
0 |
|
|
0.5 to 3.9 mg/dL |
1 |
|
|
>= 4 mg/dL |
7 |
|
age in years |
< 75 years |
0 |
|
|
>= 75 years |
3 |
|
alcohol use |
non-drinker |
2 |
|
|
drinker |
0 |
|
NSAIDS |
no |
0 |
|
|
yes |
1 |
|
number of hospital beds |
< 800 beds |
0 |
|
|
>= 800 beds |
5 |
|
heart rate |
< 100 beats per minute |
0 |
|
|
>= 100 beats per minute |
2 |
|
oral antiplatelet agent |
other than low dose aspirin |
2 |
|
|
low dose aspirin or none |
0 |
|
abdominal pain |
no |
0 |
|
|
yes |
3 |
|
diarrhea |
no |
0 |
|
|
yes |
2 |
|
tarry stool |
no |
0 |
|
|
yes |
4 |
|
systolic blood pressure |
<= 100 mm Hg |
2 |
|
|
> 100 mm Hg |
0 |
|
ECOG performance |
0 or 1 |
0 |
|
|
2 to 4 |
3 |
|
malignancy |
no |
0 |
|
|
yes |
2 |
|
inflammatory bowel disease |
no |
0 |
|
|
yes |
11 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 70
|
Score |
Length of Stay |
|
<= 5 |
5 days |
|
6 to 10 |
6 days |
|
11 to 15 |
7 days |
|
16 to 20 |
8 days |
|
21 to 25 |
10 days |
|
26 to 30 |
14 days |
|
>= 31 |
20 days |
Performance:
• The area under the ROC curve for prolonged hospital stay was 0.70 for derivation and 0.66 for validation cohorts.
Specialty: Gastroenterology
