Objective: Several mortality prediction scores are available for patients with upper gastrointestinal bleeding who visited the emergency department; however, most of the available scores include endoscopic data. Endoscopy is difficult or impossible to access for many emergencies departments worldwide. The aim of this study was to evaluate and compare the performance of the albumin, INR, alteration in mental status, systolic blood pressure and age 65 score and the Glasgow-Blatchford score in predicting mortality in patients with upper gastrointestinal bleeding who visited the emergency department and for which endoscopic data were not required.
Methods: The data of patients with acute upper gastrointestinal bleeding who visited the emergency department during the study period were retrospectively analyzed. The data were obtained from the hospital automation system using the international classification of disease codes via computer registration. The prediction accuracy of AIMS65 and Glasgow-Blatchford score was compared using the area under the receiver operating characteristic curve method.
Results: There were 422 patients in total; the mean age of these patients was 68.5 while 62.6% were males. The mortality rate was 30 (7.1%). The AIMS65 score performed better with an AUC 0.706 [95%CI 0.660-0.749; p<0.001] compared with the Glasgow-Blatchford score (AUC 0.542; 95%CI 0.4693-0.576; p=0.11).
Conclusion: In this study, it was revealed that AIMS65, which is a score that can be easily calculated only with the data in the emergency department, outperformed Glasgow-Blatchford score in predicting mortality in patients with acute upper gastrointestinal bleeding who visited the emergency department.
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http://dx.doi.org/10.1590/1806-9282.20210580 | DOI Listing |
Clin Transl Gastroenterol
January 2025
Department of Gastroenterology & Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
Background: Lugol's chromoendoscopy (LCE) is valuable, cost-effective, and widely used in early esophageal cancer (EEC) screening, yet it suffers from low compliance due to adverse events after LCE. In addition, the reflux of iodine during iodine staining in the upper esophagus brings the risk of bucking and aspiration. We introduced a new model called distance countdown (DC) aimed to reduce reflux during iodine staining in upper esophageal LCE.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, PRT.
Autoimmune polyglandular syndromes (APS) are characterized by associations of two or more autoimmune diseases (AID). APS type 3 is characterized by the presence of autoimmune thyroid disease associated with other AID, excluding adrenal gland involvement. Here we report a case of a 64-year-old male, with history of type 1 diabetes mellitus (T1DM), diagnosed at the age of 32, who was referred to a Diabetes consultation in 2014 due to poor metabolic control.
View Article and Find Full Text PDFAim: This study aimed to compare the use of remimazolam and midazolam in upper gastrointestinal endoscopy in Japan as a sub-analysis of data from an investigator-initiated clinical trial of remimazolam.
Methods And Results: Patients in two groups were matched using propensity score matching. We evaluated the time from the end of the gastrointestinal endoscopy until discharge, the time from the end of the procedure until awakening, and adverse events.
Nat Commun
January 2025
Department of Developmental Biology and Cancer Research, The Institute for Medical Research Israel Canada, The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
Gastrin is secreted following a rise in gastric pH, leading to gastric acid secretion. Sleeve gastrectomy (SG), a bariatric surgery where 80% of the gastric corpus is excised, presents a challenge for gastric pH homeostasis. Using histology, and single-cell RNA sequencing of the gastric epithelium in 12 women, we observed that SG is associated with an increase in a sub-population of acid-secreting parietal cells that overexpress respiratory enzymes and an increase in histamine-secreting enterochromaffin-like cells (ECLs).
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan Province, China.
Allergic rhinitis (AR) is a common allergic inflammatory disease that affects the upper respiratory tract. Although previous research suggests a potential association between gut microbiota alterations and AR, the causal relationship remains unclear. This study employs Mendelian randomization (MR) to reduce confounding factors and reverse causality.
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