They used data from 1748 patients admitted for upper-gastrointestinal hemorrhage. By logistic regression, we derived a risk score that predicts patients' risks of needing blood transfusion or intervention to control bleeding, rebleeding, or dying.
This score was developed into a simplified fast-track screen for use at initial presentation.
A second study prospectively validated this score using receiver operating characteristic (ROC) curves - a measure of the validity of a scoring system - and two goodness-of-fit testing with data from 197 patients. The quicker screening tool was also validated.
The team calculated risk scores from patients' admission hemoglobin, blood urea, pulse, and systolic blood pressure, as well as presentation with syncope or melena, and evidence of hepatic disease or cardiac failure. The score discriminated well with a ROC curve area of 0·92 (95%CI 0·88-0·95). The score was well calibrated for patients needing treatment (P = 0·84).
The score discriminated well with a ROC curve area of 0·92 (95%CI 0.88-0.95)
Dr Oliver Blatchford said on behalf of the team, "Our score identified patients at low or high risk of needing treatment to manage their bleeding."