Horibe et al reported the HARBINGER for identifying a patient with upper gastrointestinal bleeding who requires endoscopic management. The authors are from multiple institutions in Japan.
(1) daily proton pump use in the week before index presentation
(2) shock index
(3) blood BUN to creatinine ratio
Parameter
Finding
Points
daily proton pump use
yes
0
no
1
shock index
< 1
0
>= 1
1
BUN to creatinine ratio
< 30
0
>= 30
1
where:
• The cutoff for the urea to creatinine ratio is >= 140, which is based on BUN to urea in mmol/L factor of 0.357 and the creatinine in mmol/L with factor 0.0884, which is 4.038.
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• A score >= 2 is associated with the need for endoscopic management.
Performance:
• The area under the ROC curve is 0.74.
To read more or access our algorithms and calculators, please log in or register.