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  • 84 -5 (67) 2024 - Ismati A.O., Anosov V.D. - A COMPARATIVE ANALYSIS OF SIX PROGNOSTIC SYSTEMS FOR PREDICTING 30-DAY IN-HOSPITAL MORTALITY IN PATIENTS WITH ACUTE UPPER GASTROINTESTINAL BLEEDING

84 -5 (67) 2024 - Ismati A.O., Anosov V.D. - A COMPARATIVE ANALYSIS OF SIX PROGNOSTIC SYSTEMS FOR PREDICTING 30-DAY IN-HOSPITAL MORTALITY IN PATIENTS WITH ACUTE UPPER GASTROINTESTINAL BLEEDING

A COMPARATIVE ANALYSIS OF SIX PROGNOSTIC SYSTEMS FOR PREDICTING 30-DAY IN-HOSPITAL MORTALITY IN PATIENTS WITH ACUTE UPPER GASTROINTESTINAL BLEEDING

Ismati A.O. - Samarkand State Medical University Uzbekistan

Anosov V.D. - City Clinical Hospital No. 15 named after O.M. Filatov, Russian Federation, Moscow

Mamarajabov S.E. - Samarkand State Medical University Uzbekistan

Resume

Acute gastrointestinal bleeding (GIB) from the upper gastrointestinal (GI) tract is still a serious problem with significant incidence and mortality. Against the backdrop of advances in recent decades, effective risk stratification remains key for timely and adequate treatment. The new ABC scale has managed to establish itself as a reliable system for predicting 30-day mortality, but at present it still remains one of the least studied. Objectives: Comparison of the 30-day hospital mortality forecast results of the new ABC prognostic system with the already known Rockall score (RS), Glasgow-Blatchford Score (GBS), AIMS65, Cedars-Sinai Medical Center predictive index (CSMCPI), Progetto Nazionale Emorragia Digestive score (PNED) on groups of patients with ulcerative and variceal bleeding. Materials and methods: A retrospective single-center study involving 101 patients was carried out in the city clinical hospital No. 15 named after O.M. Filatov city of Moscow, Russian Federation. The data was collected over 4 years, from 2020 to 2023. Area under the curve analysis was used to compare scale scores for 30-day in-hospital mortality. Additional parameters describing the reliability and validity of the resulting AUROCs were also defined. Results: The study included 53 patients with ulcers and 48 patients with variceal bleeding. Mortality was 37.7% and 31.3% in the groups with ulcerative and varicose gastrointestinal tract, respectively. In predicting 30-day hospital mortality in the group with ulcer bleeding, ABC was the most effective (AUROC 0.940; 95% Cl 0.839-0.987; p <0.0001), the worst was RS (AUROC 0.648; 95% Cl 0.505-0.775; p = 0.0543) . In the variceal bleeding group, neither scale was able to demonstrate statistical superiority. Conclusion: ABC is highly effective in predicting 30-day mortality in patients with ulcerative gastrointestinal tract, superior to other known prognostic systems. However, its effectiveness is limited in patients with variceal bleeding, indicating the need for further research and validation.

Key words: gastrointestinal bleeding, scale, prognostic system, prognosis, 30-day mortality, risk stratification

First page

479

Last page

490

For citation: Ismati A.O., Anosov V.D., Mamarajabov S.E. - A COMPARATIVE ANALYSIS OF SIX PROGNOSTIC SYSTEMS FOR PREDICTING 30-DAY IN-HOSPITAL MORTALITY IN PATIENTS WITH ACUTE UPPER GASTROINTESTINAL BLEEDING//New Day in Medicine 5(67)2024 479-490 https://newdayworldmedicine.com/en/article/3758

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