Marmo et al reported the Re.Co.De (Rebleeding, Comorbidities, Deteriorating) Score to identify a patient at risk for mortality associated with nonvariceal gastrointestinal bleeding. The authors are from multiple institutions in Italy.
Patient selection: nonvariceal upper gastrointestinal bleeding
Parameters:
(1) ascites
(2) altered mental status
(3) sepsis
(4) renal failure
(5) ASA status, from 1 to 4
(6) acute myocardial infarction
(7) respiratory failure
(8) advanced neoplasia
(9) rebleeding
(10) multiorgan failure
Parameter
Finding
Points
ascites
no
0
yes
1
altered mental status
no
0
yes
1
sepsis
no
0
yes
1
renal failure
no
0
yes
1
ASA status
ASA 1
0
ASA 2
2
ASA 3
3
ASA 4
4
acute myocardial infarction
no
0
yes
2
respiratory failure
no
0
yes
2
advanced neoplasia
no
0
yes
3
rebleeding
no
0
yes
3
multiorgan failure
no
0
yes
6
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 24 (paper says 23, which may have been the maximum one seen in study)
Total Score
Risk Category
30-Day Mortality
0 or 1
low
0%
2 to 4
intermediate
5 to 24
high
48%
Performance:
• The area under the ROC curve is 0.93.
Continue Reading
