Redondo-Cerezo et al reported the MAP(ASH) score for evaluating a patient with acute upper gastrointestinal bleeding. The authors are from multiple institutions from around the world.
Patient selection: acute upper GI bleeding
Parameters:
(1) altered mental status with GCS < 15 (M)
(2) ASA score (A)
(3) pulse in beats per minute (P)
(4) serum albumin in g/dL (A)
(5) systolic blood pressure in mm Hg (S)
(6) hemoglobin in g/dL (H)
Parameter
Finding
Points
GCS
15
0
3 to 14
1
ASA
1 or 2
0
3 to 5
1
pulse
<= 100 beats per minute
0
> 100 beats per minute
1
serum albumin
>= 2.5 g/dL
0
< 2.5 g/dL
2
systolic blood pressure
>= 90 mm Hg
0
< 90 mm Hg
2
hemoglobin
>= 10 g/dL
0
< 10 g/dL
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• The higher the score the greater the 30-day mortality, the risk of rebleeding and the greater need for an intervention.
• A patient with a score >= 2 has a greater risk for 30-day mortality.
Performance:
• The area under the ROC curve is 0.74 for 30-day mortality.
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