Glasgow-Blatchford Score Predicts Post-Discharge Gastrointestinal Bleeding in Hospitalized Patients with Heart Failure
The Glasgow-Blatchford Score (GBS) is one of the most widely used scoring systems for predicting clinical outcomes for gastrointestinal bleeding (GIB). However, the clinical significance of the GBS in predicting GIB in patients with heart failure (HF) remains unclear. We conducted a prospective obse...
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| Veröffentlicht in: | Journal of clinical medicine 2020-12, Vol.9 (12), p.4083 |
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| creator | Hotsuki, Yu Sato, Yu Yoshihisa, Akiomi Watanabe, Koichiro Kimishima, Yusuke Kiko, Takatoyo Yokokawa, Tetsuro Misaka, Tomofumi Sato, Takamasa Kaneshiro, Takashi Oikawa, Masayoshi Kobayashi, Atsushi Yamaki, Takayoshi Kunii, Hiroyuki Nakazato, Kazuhiko Takeishi, Yasuchika |
| description | The Glasgow-Blatchford Score (GBS) is one of the most widely used scoring systems for predicting clinical outcomes for gastrointestinal bleeding (GIB). However, the clinical significance of the GBS in predicting GIB in patients with heart failure (HF) remains unclear.
We conducted a prospective observational study in which we collected the clinical data of a total of 2236 patients (1130 men, median 70 years old) who were admitted to Fukushima Medical University Hospital for acute decompensated HF. During the post-discharge follow-up period of a median of 1235 days, seventy-eight (3.5%) patients experienced GIB. The GBS was calculated based on blood urea nitrogen, hemoglobin, systolic blood pressure, heart rate, and history of hepatic disease. The survival classification and regression tree analysis revealed that the accurate cut-off point of the GBS in predicting post-discharge GIB was six points. The patients were divided into two groups: the high GBS group (GBS > 6,
= 702, 31.4%) and the low GBS group (GBS ≤ 6,
= 1534, 68.6%). The Kaplan-Meier analysis showed that GIB rates were higher in the high GBS group than in the low GBS group. Multivariate Cox proportional hazards analysis adjusted for age, malignant tumor, and albumin indicated that a high GBS was an independent predictor of GIB (hazards ratio 2.258, 95% confidence interval 1.326-3.845,
= 0.003).
A high GBS is an independent predictor and useful risk stratification score of post-discharge GIB in patients with HF. |
| doi_str_mv | 10.3390/jcm9124083 |
| format | Article |
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We conducted a prospective observational study in which we collected the clinical data of a total of 2236 patients (1130 men, median 70 years old) who were admitted to Fukushima Medical University Hospital for acute decompensated HF. During the post-discharge follow-up period of a median of 1235 days, seventy-eight (3.5%) patients experienced GIB. The GBS was calculated based on blood urea nitrogen, hemoglobin, systolic blood pressure, heart rate, and history of hepatic disease. The survival classification and regression tree analysis revealed that the accurate cut-off point of the GBS in predicting post-discharge GIB was six points. The patients were divided into two groups: the high GBS group (GBS > 6,
= 702, 31.4%) and the low GBS group (GBS ≤ 6,
= 1534, 68.6%). The Kaplan-Meier analysis showed that GIB rates were higher in the high GBS group than in the low GBS group. Multivariate Cox proportional hazards analysis adjusted for age, malignant tumor, and albumin indicated that a high GBS was an independent predictor of GIB (hazards ratio 2.258, 95% confidence interval 1.326-3.845,
= 0.003).
A high GBS is an independent predictor and useful risk stratification score of post-discharge GIB in patients with HF.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm9124083</identifier><identifier>PMID: 33348860</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Anticoagulants ; Blood pressure ; Body mass index ; Cardiology ; Cardiovascular disease ; Clinical medicine ; Comorbidity ; Creatinine ; Diabetes ; Endoscopy ; Heart failure ; Heart rate ; Hemodialysis ; Hemoglobin ; Hospitalization ; Laboratories ; Medical prognosis ; Mortality ; Nitrogen ; Patients ; Peptides ; Tomography ; Ulcers ; Variables ; Vital signs</subject><ispartof>Journal of clinical medicine, 2020-12, Vol.9 (12), p.4083</ispartof><rights>2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 by the authors. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c406t-d870303b2d14c7abd4a5c53f1665427c7b5e6b597208b8437621d18f7f8b4ccd3</citedby><cites>FETCH-LOGICAL-c406t-d870303b2d14c7abd4a5c53f1665427c7b5e6b597208b8437621d18f7f8b4ccd3</cites><orcidid>0000-0003-1084-6475 ; 0000-0002-1273-4074 ; 0000-0003-4795-9334</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766138/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766138/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33348860$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hotsuki, Yu</creatorcontrib><creatorcontrib>Sato, Yu</creatorcontrib><creatorcontrib>Yoshihisa, Akiomi</creatorcontrib><creatorcontrib>Watanabe, Koichiro</creatorcontrib><creatorcontrib>Kimishima, Yusuke</creatorcontrib><creatorcontrib>Kiko, Takatoyo</creatorcontrib><creatorcontrib>Yokokawa, Tetsuro</creatorcontrib><creatorcontrib>Misaka, Tomofumi</creatorcontrib><creatorcontrib>Sato, Takamasa</creatorcontrib><creatorcontrib>Kaneshiro, Takashi</creatorcontrib><creatorcontrib>Oikawa, Masayoshi</creatorcontrib><creatorcontrib>Kobayashi, Atsushi</creatorcontrib><creatorcontrib>Yamaki, Takayoshi</creatorcontrib><creatorcontrib>Kunii, Hiroyuki</creatorcontrib><creatorcontrib>Nakazato, Kazuhiko</creatorcontrib><creatorcontrib>Takeishi, Yasuchika</creatorcontrib><title>Glasgow-Blatchford Score Predicts Post-Discharge Gastrointestinal Bleeding in Hospitalized Patients with Heart Failure</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>The Glasgow-Blatchford Score (GBS) is one of the most widely used scoring systems for predicting clinical outcomes for gastrointestinal bleeding (GIB). However, the clinical significance of the GBS in predicting GIB in patients with heart failure (HF) remains unclear.
We conducted a prospective observational study in which we collected the clinical data of a total of 2236 patients (1130 men, median 70 years old) who were admitted to Fukushima Medical University Hospital for acute decompensated HF. During the post-discharge follow-up period of a median of 1235 days, seventy-eight (3.5%) patients experienced GIB. The GBS was calculated based on blood urea nitrogen, hemoglobin, systolic blood pressure, heart rate, and history of hepatic disease. The survival classification and regression tree analysis revealed that the accurate cut-off point of the GBS in predicting post-discharge GIB was six points. The patients were divided into two groups: the high GBS group (GBS > 6,
= 702, 31.4%) and the low GBS group (GBS ≤ 6,
= 1534, 68.6%). The Kaplan-Meier analysis showed that GIB rates were higher in the high GBS group than in the low GBS group. Multivariate Cox proportional hazards analysis adjusted for age, malignant tumor, and albumin indicated that a high GBS was an independent predictor of GIB (hazards ratio 2.258, 95% confidence interval 1.326-3.845,
= 0.003).
A high GBS is an independent predictor and useful risk stratification score of post-discharge GIB in patients with HF.</description><subject>Anticoagulants</subject><subject>Blood pressure</subject><subject>Body mass index</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Clinical medicine</subject><subject>Comorbidity</subject><subject>Creatinine</subject><subject>Diabetes</subject><subject>Endoscopy</subject><subject>Heart failure</subject><subject>Heart rate</subject><subject>Hemodialysis</subject><subject>Hemoglobin</subject><subject>Hospitalization</subject><subject>Laboratories</subject><subject>Medical prognosis</subject><subject>Mortality</subject><subject>Nitrogen</subject><subject>Patients</subject><subject>Peptides</subject><subject>Tomography</subject><subject>Ulcers</subject><subject>Variables</subject><subject>Vital signs</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkV1LHDEYhYNYVLbe-AMk4I0Ups3XJNkbQa3uFoQuVK9DJsnsZslO1iSjtL_eFK0ffW_yQh4O5z0HgCOMvlI6Rd_WZjPFhCFJd8ABQUI0iEq6-27fB4c5r1EdKRnBYg_sU0qZlBwdgIdZ0HkZH5uLoItZ9TFZ-MvE5OAiOetNyXARc2m--2xWOi0dnOlcUvRDcbn4QQd4EVwlhyX0A5zHvPVFB__HWbjQxbuhKjz6soJzp1OB19qHMbnP4FOvQ3aHL-8E3F1f3V7Om5ufsx-X5zeNYYiXxkqBKKIdsZgZoTvLdGta2mPOW0aEEV3reNdOBUGyk4wKTrDFshe97Jgxlk7A2bPuduw2zppqJ-mgtslvdPqtovbq48_gV2oZH5QQnOMa3gScvgikeD_Wk9WmJuFC0IOLY1aECYIRR7St6Ml_6DqOqSZUKc4wbjmjpFJfnimTYs7J9a9mMFJ_G1VvjVb4-L39V_Rff_QJ8-mdVA</recordid><startdate>20201217</startdate><enddate>20201217</enddate><creator>Hotsuki, Yu</creator><creator>Sato, Yu</creator><creator>Yoshihisa, Akiomi</creator><creator>Watanabe, Koichiro</creator><creator>Kimishima, Yusuke</creator><creator>Kiko, Takatoyo</creator><creator>Yokokawa, Tetsuro</creator><creator>Misaka, Tomofumi</creator><creator>Sato, Takamasa</creator><creator>Kaneshiro, Takashi</creator><creator>Oikawa, Masayoshi</creator><creator>Kobayashi, Atsushi</creator><creator>Yamaki, Takayoshi</creator><creator>Kunii, Hiroyuki</creator><creator>Nakazato, Kazuhiko</creator><creator>Takeishi, Yasuchika</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1084-6475</orcidid><orcidid>https://orcid.org/0000-0002-1273-4074</orcidid><orcidid>https://orcid.org/0000-0003-4795-9334</orcidid></search><sort><creationdate>20201217</creationdate><title>Glasgow-Blatchford Score Predicts Post-Discharge Gastrointestinal Bleeding in Hospitalized Patients with Heart Failure</title><author>Hotsuki, Yu ; Sato, Yu ; Yoshihisa, Akiomi ; Watanabe, Koichiro ; Kimishima, Yusuke ; Kiko, Takatoyo ; Yokokawa, Tetsuro ; Misaka, Tomofumi ; Sato, Takamasa ; Kaneshiro, Takashi ; Oikawa, Masayoshi ; Kobayashi, Atsushi ; Yamaki, Takayoshi ; Kunii, Hiroyuki ; Nakazato, Kazuhiko ; Takeishi, Yasuchika</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c406t-d870303b2d14c7abd4a5c53f1665427c7b5e6b597208b8437621d18f7f8b4ccd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Anticoagulants</topic><topic>Blood pressure</topic><topic>Body mass index</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Clinical medicine</topic><topic>Comorbidity</topic><topic>Creatinine</topic><topic>Diabetes</topic><topic>Endoscopy</topic><topic>Heart failure</topic><topic>Heart rate</topic><topic>Hemodialysis</topic><topic>Hemoglobin</topic><topic>Hospitalization</topic><topic>Laboratories</topic><topic>Medical prognosis</topic><topic>Mortality</topic><topic>Nitrogen</topic><topic>Patients</topic><topic>Peptides</topic><topic>Tomography</topic><topic>Ulcers</topic><topic>Variables</topic><topic>Vital signs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hotsuki, Yu</creatorcontrib><creatorcontrib>Sato, Yu</creatorcontrib><creatorcontrib>Yoshihisa, Akiomi</creatorcontrib><creatorcontrib>Watanabe, Koichiro</creatorcontrib><creatorcontrib>Kimishima, Yusuke</creatorcontrib><creatorcontrib>Kiko, Takatoyo</creatorcontrib><creatorcontrib>Yokokawa, Tetsuro</creatorcontrib><creatorcontrib>Misaka, Tomofumi</creatorcontrib><creatorcontrib>Sato, Takamasa</creatorcontrib><creatorcontrib>Kaneshiro, Takashi</creatorcontrib><creatorcontrib>Oikawa, Masayoshi</creatorcontrib><creatorcontrib>Kobayashi, Atsushi</creatorcontrib><creatorcontrib>Yamaki, Takayoshi</creatorcontrib><creatorcontrib>Kunii, Hiroyuki</creatorcontrib><creatorcontrib>Nakazato, Kazuhiko</creatorcontrib><creatorcontrib>Takeishi, Yasuchika</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hotsuki, Yu</au><au>Sato, Yu</au><au>Yoshihisa, Akiomi</au><au>Watanabe, Koichiro</au><au>Kimishima, Yusuke</au><au>Kiko, Takatoyo</au><au>Yokokawa, Tetsuro</au><au>Misaka, Tomofumi</au><au>Sato, Takamasa</au><au>Kaneshiro, Takashi</au><au>Oikawa, Masayoshi</au><au>Kobayashi, Atsushi</au><au>Yamaki, Takayoshi</au><au>Kunii, Hiroyuki</au><au>Nakazato, Kazuhiko</au><au>Takeishi, Yasuchika</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Glasgow-Blatchford Score Predicts Post-Discharge Gastrointestinal Bleeding in Hospitalized Patients with Heart Failure</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2020-12-17</date><risdate>2020</risdate><volume>9</volume><issue>12</issue><spage>4083</spage><pages>4083-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>The Glasgow-Blatchford Score (GBS) is one of the most widely used scoring systems for predicting clinical outcomes for gastrointestinal bleeding (GIB). However, the clinical significance of the GBS in predicting GIB in patients with heart failure (HF) remains unclear.
We conducted a prospective observational study in which we collected the clinical data of a total of 2236 patients (1130 men, median 70 years old) who were admitted to Fukushima Medical University Hospital for acute decompensated HF. During the post-discharge follow-up period of a median of 1235 days, seventy-eight (3.5%) patients experienced GIB. The GBS was calculated based on blood urea nitrogen, hemoglobin, systolic blood pressure, heart rate, and history of hepatic disease. The survival classification and regression tree analysis revealed that the accurate cut-off point of the GBS in predicting post-discharge GIB was six points. The patients were divided into two groups: the high GBS group (GBS > 6,
= 702, 31.4%) and the low GBS group (GBS ≤ 6,
= 1534, 68.6%). The Kaplan-Meier analysis showed that GIB rates were higher in the high GBS group than in the low GBS group. Multivariate Cox proportional hazards analysis adjusted for age, malignant tumor, and albumin indicated that a high GBS was an independent predictor of GIB (hazards ratio 2.258, 95% confidence interval 1.326-3.845,
= 0.003).
A high GBS is an independent predictor and useful risk stratification score of post-discharge GIB in patients with HF.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>33348860</pmid><doi>10.3390/jcm9124083</doi><orcidid>https://orcid.org/0000-0003-1084-6475</orcidid><orcidid>https://orcid.org/0000-0002-1273-4074</orcidid><orcidid>https://orcid.org/0000-0003-4795-9334</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; PubMed Central |
| subjects | Anticoagulants Blood pressure Body mass index Cardiology Cardiovascular disease Clinical medicine Comorbidity Creatinine Diabetes Endoscopy Heart failure Heart rate Hemodialysis Hemoglobin Hospitalization Laboratories Medical prognosis Mortality Nitrogen Patients Peptides Tomography Ulcers Variables Vital signs |
| title | Glasgow-Blatchford Score Predicts Post-Discharge Gastrointestinal Bleeding in Hospitalized Patients with Heart Failure |
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