Zhongguo quanke yixue (Feb 2022)
[Article title missing]
Abstract
BackgroundAcute gastrointestinal bleeding (AGB) is one of the common emergencies for patients of emergency department. How to quickly and accurately stratify the risk of AGB is essential to improving the prognosis. Therefore, a simple, fast and easy-to-operate method is needed to early detect emergency patients at high-risk of AGB.ObjectiveTo compare the predictive value of shock index (SI), age shock index (ASI) and modified shock index (MSI) in the stratification of adverse outcomes in patients with AGB.MethodsA retrospective design was used. Participants with AGB were selected from Department of Emergency, Hainan General Hospital from 2019 to 2020. Vital signs and calculated SI, ASI and MSI of patients were collected by the triage nurse, and their predictive values for the admission to the ICU, blood transfusion, endoscopic/colonoscopy (E/C) intervention and death were comparatively analyzed.ResultsAltogether, 302 cases were enrolled. Among them, 158 (52.32%) had at least one adverse outcome, 38 (12.58%) were admitted to the ICU, 136 (45.03%) received blood transfusion, 54 (17.88%) received E/C intervention, and 12 (3.97%) died. The average SI, ASI and MSI of patients with adverse outcomes were all higher than those without (P<0.05). SI, ASI and MSI were all of statistical significance in predicting the adverse outcomes (P<0.05). Specifically, ASI had a larger AUC than SI (P=0.013) and MSI (P=0.024) for predicting adverse outcomes in AGB, but the AUC of SI was similar to that of MSI (P=0.985). Both SI and ASI were of statistical significance in predicting theadmission to the ICU (P<0.05). SI, ASI and MSI were all of statistical significance in predicting the requirement for blood transfusion (P<0.05). SI was of statistical significance in predicting the requirement for E/C intervention (P<0.05). The cut-off point of ASI predicting adverse outcomes in AGB was 45.12. Spearman correlation analysis indicated that the number of adverse outcomes in AGB had a positive relation with SI (rs=0.255, P=0.002), ASI (rs=0.360, P<0.001) and MSI (rs=0.246, P=0.002) .ConclusionASI is easy to be calculated during the triage phase, and it may be superior to both SI and MSI in terms of predicting adverse outcomes in AGB.
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