The PNED (Progetto Nazionale EmorragiaDigestiva) score can help to identify a patient with nonvariceal upper gastrointestinal bleeding who is at increased risk of 30-day mortality. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in Italy.
Patient selection: adult with nonvariceal upper gastrointestinal hemorrhage
Parameters:
(1) ASA status
(2) hemoglobin in g/dL
(3) rebleeding
(4) results of endoscopic treatment
(5) time to admission in hours
(6) age in years
(7) renal failure
(8) neoplasia
(9) liver cirrhosis
Parameter
Finding
Points
ASA status
1 or 2
0
3
1
4
3
hemoglobin
> 7 g/dL
0
<= 7 g/dL
2
rebleeding
no
0
yes
3
endoscopic treatment
effective
0
failure
4
time to admission
< 8 hours
1
>= 8 hours
0
age
< 80 years
0
>= 80 years
2
renal failure
no
0
yes
2
neoplasia
no
0
yes
3
cirrhosis
no
0
yes
3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 23
Total Score
30-day Mortality
0 or 1
1-2%
2 to 4
3-4%
5 to 8
5-10%
>= 9
30%
Performance:
• The area under the ROC curve is 0.81
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