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Meram E, Russell E, Ozkan O, Kleedehn M. Variceal and Nonvariceal Upper Gastrointestinal Bleeding Refractory to Endoscopic Management: Indications and Role of Interventional Radiology. Gastrointest Endosc Clin N Am 2024; 34:275-299. [PMID: 38395484 DOI: 10.1016/j.giec.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
For over 60 years, diagnostic and interventional radiology have been heavily involved in the evaluation and treatment of patients presenting with gastrointestinal bleeding. For patients who present with upper GI bleeding and have a contraindication to endoscopy or have an unsuccessful attempt at endoscopy for identifying or controlling the bleeding, interventional radiology is often consulted for evaluation and consideration of catheter-based intervention.
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Affiliation(s)
- Ece Meram
- University of Wisconsin School of Medicine and Public Health, University of Wisconsin Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792, USA
| | - Elliott Russell
- University of Wisconsin School of Medicine and Public Health, University of Wisconsin Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792, USA
| | - Orhan Ozkan
- University of Wisconsin School of Medicine and Public Health, University of Wisconsin Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792, USA
| | - Mark Kleedehn
- University of Wisconsin School of Medicine and Public Health, University of Wisconsin Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792, USA.
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2
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Zeng F, Du L, Ling L. Lactate level as a predictor of outcomes in patients with acute upper gastrointestinal bleeding: A systematic review and meta‑analysis. Exp Ther Med 2024; 27:113. [PMID: 38361514 PMCID: PMC10867736 DOI: 10.3892/etm.2024.12401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 11/22/2023] [Indexed: 02/17/2024] Open
Abstract
There remains no consensus on the prognostic value of lactate in predicting adverse outcomes such as mortality, rebleeding and higher intensive care unit (ICU) admission rates in patients with upper gastrointestinal bleeding (UGIB). The present study aimed to determine the prognostic accuracy of lactate level in predicting adverse clinical outcomes in patients with acute UGIB. Systematic literature search was conducted in PubMed Central, SCOPUS, EMBASE, MEDLINE, Google Scholar and ScienceDirect databases for studies published up to February 2023. Random-effects model was used for the meta-analysis and the results were presented as pooled standardized mean differences or odds ratio (OR) with 95% confidence interval (CIs). A total of 11 studies were included in the present review. Most of the studies had a high risk of bias. Pooled OR were as follows: 1.39 (95% CI: 1.29-1.51; I2=85%) for the prediction of mortality; 1.29 (95% CI: 1.17-1.42; I2=85.9%) for prediction of ICU admission, 1.14 (95% CI: 1.06-1.23; I2=42.4%) for rebleeding and 2.84 (95% CI: 2.14-3.77; I2=8.1%) for the need of packed red blood cell (pRBC) transfusion. Sensitivity and specificity for the mortality prediction were 72% (95% CI: 57-83%) and 75% (95% CI: 61-85%), respectively, with the area under the curve of 0.79 (95% CI: 0.72-0.85). In conclusion, the results showed that lactate level is a moderately accurate early prediction marker of most adverse clinical outcomes such as mortality, rebleeding, ICU admission and the need for pRBC transfusion in acute UGIB patients.
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Affiliation(s)
- Fanshu Zeng
- Department of Emergency, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, P.R. China
| | - Li Du
- Department of Gastroenterology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, P.R. China
| | - Ling Ling
- Department of Radiology Center, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, P.R. China
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Zhang X, Ni J, Zhang H, Diao M. A nomogram to predict in-hospital mortality of gastrointestinal bleeding patients in the intensive care unit. Front Med (Lausanne) 2023; 10:1204099. [PMID: 37731712 PMCID: PMC10507729 DOI: 10.3389/fmed.2023.1204099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/21/2023] [Indexed: 09/22/2023] Open
Abstract
Background Gastrointestinal bleeding (GIB) is a common condition in clinical practice, and predictive models for patients with GIB have been developed. However, assessments of in-hospital mortality due to GIB in the intensive care unit (ICU), especially in critically ill patients, are still lacking. This study was designed to screen out independent predictive factors affecting in-hospital mortality and thus establish a predictive model for clinical use. Methods This retrospective study included 1,442 patients with GIB who had been admitted to the ICU. They were selected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) 1.0 database and divided into a training group and a validation group in a ratio of 7:3. The main outcome measure was in-hospital mortality. Least absolute shrinkage and section operator (LASSO) regression was used to screen out independent predictors and create a nomogram. Results LASSO regression picked out nine independent predictors: heart rate (HR), activated partial thromboplastin time (aPTT), acute physiology score III (APSIII), sequential organ failure assessment (SOFA), cerebrovascular disease, acute kidney injury (AKI), norepinephrine, vasopressin, and dopamine. Our model proved to have excellent predictive value with regard to in-hospital mortality (the area under the receiver operating characteristic curve was 0.906 and 0.881 in the training and validation groups, respectively), as well as a good outcome on a decision curve analysis to assess net benefit. Conclusion Our model effectively predicts in-hospital mortality in patients with GIB, indicating that it may prove to be a valuable tool in future clinical practice.
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Affiliation(s)
- Xueyan Zhang
- Geriatric Medicine Center, Department of Geriatric Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jianfang Ni
- Geriatric Medicine Center, Department of Geriatric Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Hongwei Zhang
- Department of Critical Care Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mengyuan Diao
- Department of Critical Care Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Jimenez-Rosales R, Lopez-Tobaruela JM, Lopez-Vico M, Ortega-Suazo EJ, Martinez-Cara JG, Redondo-Cerezo E. Performance of the New ABC and MAP(ASH) Scores in the Prediction of Relevant Outcomes in Upper Gastrointestinal Bleeding. J Clin Med 2023; 12:jcm12031085. [PMID: 36769733 PMCID: PMC9917936 DOI: 10.3390/jcm12031085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/14/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Background & Aims: Several risk scores have been proposed for risk-stratification of patients with upper gastrointestinal bleeding. ABC score was found more accurate predicting mortality than AIMS65. MAP(ASH) is a simple, pre-endoscopy score with a great ability to predict intervention and mortality. The aim of this study was to compare ABC and MAP(ASH) discriminative ability for the prediction of mortality and intervention in UGIB. As a secondary aim we compared both scores with Glasgow-Blatchford score and AIMS65. Methods: Our study included patients admitted to the emergency room of Virgen de las Nieves University Hospital with UGIB (2017-2020). Information regarding clinical, biochemical tests and procedures was collected. Main outcomes were in-hospital mortality and a composite endpoint for intervention. Results: MAP(ASH) and ABC had similar AUROCs for mortality (0.79 vs. 0.80). For intervention, MAP(ASH) (AUROC = 0.75) and ABC (AUROC = 0.72) were also similar. Regarding rebleeding, AUROCs of MAP(ASH) and ABC were 0.67 and 0.61 respectively. No statistically differences were found in these outcomes. With a low threshold for MAP(ASH) ≤ 2, ABC and MAP(ASH) classified a similar proportion of patients as being at low risk of death (42% vs. 45.2%), with virtually no mortality under these thresholds. Conclusions: MAP(ASH) and ABC were similar for the prediction of relevant outcomes for UGIB, such as intervention, rebleeding and in-hospital mortality, with an accurate selection of low-risk patients. MAP(ASH) has the advantage of being easier to calculate even without the aid of electronic tools.
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Affiliation(s)
- Rita Jimenez-Rosales
- Department of Gastroenterology, “Virgen de las Nieves” University Hospital, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain
| | - Jose Maria Lopez-Tobaruela
- Department of Gastroenterology, “Virgen de las Nieves” University Hospital, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain
- University of Granada, 18010 Granada, Spain
- Correspondence:
| | - Manuel Lopez-Vico
- Department of Gastroenterology, “Virgen de las Nieves” University Hospital, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain
| | - Eva Julissa Ortega-Suazo
- Department of Gastroenterology, “Virgen de las Nieves” University Hospital, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain
| | - Juan Gabriel Martinez-Cara
- Department of Gastroenterology, “Virgen de las Nieves” University Hospital, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain
| | - Eduardo Redondo-Cerezo
- Department of Gastroenterology, “Virgen de las Nieves” University Hospital, Avenida de las Fuerzas Armadas 2, 18014 Granada, Spain
- Department of Medicine, School of Medicine, University of Granada, 18016 Granada, Spain
- Biosanitary Institute of Granada (ibs.GRANADA), 18014 Granada, Spain
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Dogru U, Yuksel M, Ay MO, Kaya H, Ozdemır A, Isler Y, Bulut M. The effect of the shock index and scoring systems for predicting mortality among geriatric patients with upper gastrointestinal bleeding: a prospective cohort study. SAO PAULO MED J 2022; 140:531-539. [PMID: 35544884 PMCID: PMC9491474 DOI: 10.1590/1516-3180.2021.0735.13102021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/13/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Gastrointestinal (GI) bleeding is an important cause of mortality and morbidity among geriatric patients. OBJECTIVE To investigate whether the shock index and other scoring systems are effective predictors of mortality and prognosis among geriatric patients presenting to the emergency department with complaints of upper GI bleeding. DESIGN AND SETTING Prospective cohort study in an emergency department in Bursa, Turkey. METHODS Patients over 65 years admitted to a single-center, tertiary emergency service between May 8, 2019, and April 30, 2020, and diagnosed with upper GI bleeding were analyzed. 30, 180 and 360-day mortality prediction performances of the shock index and the Rockall, Glasgow-Blatchford and AIMS-65 scores were evaluated. RESULTS A total of 111 patients who met the criteria were included in the study. The shock index (P < 0.001) and AIMS-65 score (P < 0.05) of the patients who died within the 30-day period were found to be significantly different, while the shock index (P < 0.001), Rockall score (P < 0.001) and AIMS-65 score (P < 0.05) of patients who died within the 180-day and 360-day periods were statistically different. In the receiver operating characteristic (ROC) analysis for predicting 360-day mortality, the area under the curve (AUC) value was found to be 0.988 (95% confidence interval, CI, 0.971-1.000; P < 0.001). CONCLUSION The shock index measured among geriatric patients with upper GI bleeding at admission seems to be a more effective predictor of prognosis than other scoring systems.
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Affiliation(s)
- Umran Dogru
- MD. Emergency Medicine Specialist, Department of Emergency Medicine, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Melih Yuksel
- MD. Associate Professor of Emergency Medicine, Department of Emergency Medicine, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Mehmet Oguzhan Ay
- MD. Associate Professor of Emergency Medicine, Department of Emergency Medicine, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Halil Kaya
- MD. Professor of Emergency Medicine, Department of Emergency Medicine, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Aksel Ozdemır
- MD. Emergency Medicine Specialist, Department of Emergency Medicine, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Yesim Isler
- MD. Emergency Medicine Specialist, Department of Emergency Medicine, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Mehtap Bulut
- MD. Professor of Emergency Medicine, Department of Emergency Medicine, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
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Saade MC, Kerbage A, Jabak S, Makki M, Barada K, Shaib Y. Validation of the new ABC score for predicting 30-day mortality in gastrointestinal bleeding. BMC Gastroenterol 2022; 22:301. [PMID: 35729498 PMCID: PMC9209314 DOI: 10.1186/s12876-022-02374-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND/AIM The ABC score is a new pre-endoscopic scoring system that was recently developed to accurately predict one-month mortality in upper and lower gastrointestinal bleeding (GIB). We aim to validate this new score on a cohort of Lebanese patients treated in a tertiary care center and to compare it to currently existing scores. METHODS Adult patients admitted to the American University of Beirut Medical Center (AUBMC) with overt GIB between January 2013 and August 2020 were included. The area under receiver operating characteristic (AUROC) curves of the ABC score in predicting 30-day mortality was calculated using the SPSS software. Other optimal existing scores for predicting mortality (the Oakland score for lower GIB, the AIMS-65 and the Rockall scores for upper GIB)s were also assessed and compared to the ABC score. RESULTS A total of 310 patients were included in our study. For upper GIB, the ABC score showed good performance in predicting 30-day mortality (AUROC: 0.79), outperforming both the AIMS-65 score (AUROC 0.67, p < 0.001) and the Rockall score (AUROC: 0.62, p < 0.001). For lower GIB, the ABC score also had good performance which was comparable to the Oakland score (AUROC: 0.70 vs 0.56, p = 0.26). CONCLUSION In our cohort of patients, the ABC score demonstrated good performance in predicting 30-day mortality for patients with upper and lower GIB compared to other established risk scores, which may help guide management decisions. This simple and novel score provides valuable prognostic information for patients presenting with GIB and appears to be reproducible in different patient populations.
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Affiliation(s)
- Marie Christelle Saade
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Anthony Kerbage
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Suha Jabak
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maha Makki
- Biostatistics Support Unit, Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Kassem Barada
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Yasser Shaib
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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Björkman J, Raatiniemi L, Setälä P, Nurmi J. Shock index as a predictor for short-term mortality in helicopter emergency medical services: A registry study. Acta Anaesthesiol Scand 2021; 65:816-823. [PMID: 33340090 DOI: 10.1111/aas.13765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/26/2020] [Accepted: 11/29/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND The value of shock-index has been demonstrated in hospital triage, but few studies have evaluated its prehospital use. The aim of our study was to evaluate the association between shock-index in prehospital critical care and short-term mortality. METHODS We analyzed data from the national helicopter emergency medical services database and the Population Register Centre. The shock-index was calculated from the patients' first measured parameters. The primary outcome measure was 1- and 30-day mortality. RESULTS A total of 22 433 patients were included. The 1-day mortality was 7.5% and 30-day mortality was 16%. The median shock-index was 0.68 (0.55/0.84) for survivors and 0.67 (0.49/0.93) for non-survivors (P = .316) at 30-days. Association between shock-index and mortality followed a U-shaped curve in trauma (shock-index < 0.5: odds ratio 2.5 [95% confidence interval 1.8-3.4], shock-index > 1.3: odds ratio 4.4 [2.7-7.2] at 30 days). Patients with neurological emergencies with a low shock-index had an increased risk of mortality (shock-index < 0.5: odds ratio 1.8 [1.5-2.3]) whereas patients treated after successful resuscitation from out-of-hospital cardiac arrest, a higher shock-index was associated with higher mortality (shock-index > 1.3: odds ratio 3.5 [2.3-5.4). The association was similar for all ages, but older patients had higher mortality in each shock-index category. CONCLUSION The shock-index is associated with short time mortality in most critical patient categories in the prehospital setting. However, the marked overlap of shock-index in survivors and non-survivors in all patient categories limits its predictive value.
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Affiliation(s)
- Johannes Björkman
- FinnHEMS Research and Development Unit Vantaa Finland
- University of Helsinki Helsinki Finland
| | - Lasse Raatiniemi
- Centre for Emergency Medical Services Oulu University Hospital Oulu Finland
| | - Piritta Setälä
- Emergency Medical Services Tampere University Hospital Tampere Finland
| | - Jouni Nurmi
- FinnHEMS Research and Development Unit Vantaa Finland
- Emergency Medicine and Services Helsinki University Hospital and Emergency MedicineUniversity of Helsinki Helsinki Finland
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Kocaoğlu S, Çetinkaya HB. Use of age shock index in determining severity of illness in patients presenting to the emergency department with gastrointestinal bleeding. Am J Emerg Med 2021; 47:274-278. [PMID: 33993044 DOI: 10.1016/j.ajem.2021.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/24/2021] [Accepted: 05/02/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES This study aimed to make a comparison between classical shock index (SI), modified shock index (MSI), and age shock index (age SI) for predicting critical patients presenting to the emergency department (ED) with gastrointestinal bleeding (GIS). METHODS The study, which was planned retrospectively, consisted of patients diagnosed with GIS bleeding at the ED admission. Triage time vital signs were used to calculate SI, MSI, and age SI. These results were compared with intensive care admission, endoscopic/colonoscopic (E/C) intervention, blood transfusion, and mortality criteria, which we define as adverse outcomes. RESULTS The study included 151 patients. Seventy-nine (52.32%) of the patients had at least one adverse outcome. Of the 151 patients, 19 (12.58%) had ICU admission, 27 (17.88%) underwent endoscopic/colonoscopic (E/C) intervention, 68 (45.03%) received a blood transfusion, and 6 (3.97%) died. There was a significant difference between patients who had no adverse outcome and those who had at least one adverse outcome in terms of SI, age SI, and MSI. We performed ROC curve analyses to evaluate the diagnostic performances of all indices for predicting adverse outcomes. AUC (area under the curve) values for age SI was the highest (age SI AUC = 0.711, p < 0.001; SI AUC = 0.616; MSI AUC = 0.617). The performance of the age SI was significantly higher than the SI (p = 0.013) and the MSI (p = 0.024) for predicting adverse outcomes. The cut-off value for the age shock index was 45.12. CONCLUSIONS In patients with GIS bleeding, age SI, which can be easily calculated in triage, is more significant than SI and MSI for predicting the critical patient.
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Affiliation(s)
- Salih Kocaoğlu
- Department of Emergency Medicine, Balıkesir University Faculty of Medicine, Balıkesir, Turkey.
| | - Hasan Basri Çetinkaya
- Department of Emergency Medicine, Balıkesir University Faculty of Medicine, Balıkesir, Turkey
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Wang H, Cao F, Yang J, Wu Y, Wang L. The Clinical Value of Multislice Spiral Computed Tomography in the Diagnosis of Upper Digestive Tract Diseases. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6673712. [PMID: 33815731 PMCID: PMC7990549 DOI: 10.1155/2021/6673712] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 03/01/2021] [Accepted: 03/08/2021] [Indexed: 12/19/2022]
Abstract
Imaging methods for gastrointestinal diseases were based on X-ray imaging until the 1970s, but the development of fiberoptic endoscopy in the 1980s has replaced X-ray imaging. Endoscopy can directly observe the location, size, scope, and color of lesions and obtain pathological results through biopsy, while ligation and other treatments can be performed on polyps and other lesions. Studies have shown that multilayer spiral computed tomography (CT) examination after standardized gastrointestinal preparation and full use of the advantages of various 3D postprocessing reconstruction techniques are of great clinical value in the detection of gastrointestinal diseases, determination of the nature of lesions, localization of lesions, and staging of gastrointestinal malignancies and can make up for the shortcomings of fiberoptic endoscopy, and various 3D postprocessing reconstruction modes have their own advantages and disadvantages. Among them, conventional CT cross-sectional images are the basic images for the diagnosis of various gastric testicular lesions. Axial images, especially thin-layer axial images, can detect the absolute majority of lesions, but there are limitations in observing the anatomical position of lesions, invasion of surrounding tissues, lymph node metastasis, vascularity, and determination of the stage of malignant tumors.
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Affiliation(s)
- Huali Wang
- School of Mathematics and Statistics, Hubei University of Arts and Science, Xiangyang, Hubei 441000, China
| | - Feng Cao
- Department of Radiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei 441000, China
| | - Jiaqi Yang
- Medical College of China Three Gorges University, Yichang, Hubei 443002, China
| | - Yongjuan Wu
- Department of Radiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei 441000, China
| | - Lin Wang
- Department of Gastroenterology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei 441000, China
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Stanley A. Letter: the Shock Index and predicting outcomes in patients with upper gastrointestinal bleeding. Author's reply. Aliment Pharmacol Ther 2020; 51:312-313. [PMID: 31880011 DOI: 10.1111/apt.15615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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11
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Bardou M, Barkun AN. Editorial: how can we best promote the routine use of scores that are accurate at predicting outcomes in patients with upper gastrointestinal bleeding? Aliment Pharmacol Ther 2020; 51:305-306. [PMID: 31880013 DOI: 10.1111/apt.15574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Marc Bardou
- CIC 1432 & Gastroenterology Department, CHU Dijon-Bourgogne, Dijon, France.,Université Bourgogne Franche-Comté, UFR des Sciences Santé, Dijon, France
| | - Alan N Barkun
- Division of Gastroenterology, Montreal General Hospital Site, The McGill University Health Centre, McGill University, Montreal, QC, Canada
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12
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McPherson SJ, Hammond CJ. Letter: the Shock Index and predicting outcomes in patients with upper gastrointestinal bleeding. Aliment Pharmacol Ther 2020; 51:311-312. [PMID: 31880019 DOI: 10.1111/apt.15605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Simon J McPherson
- Department of Vascular Interventional Radiology, Leeds Teaching Hospitals Trust, Leeds, UK.,National Confidential Enquiry into Patient Outcome and Death (NCEPOD), London, UK
| | - Christopher J Hammond
- Department of Vascular Interventional Radiology, Leeds Teaching Hospitals Trust, Leeds, UK
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