A multicentre development and validation study of a novel Lower Gastrointestinal Bleeding score-The Birmingham Score

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A multicentre development and validation study of a novel Lower Gastrointestinal Bleeding score-The Birmingham Score. / Smith, Samuel; Bazarova, Alina; Ejenavi , Efe; Qurashi, Maria ; Shivaji, Uday; Harvey , Phil R; Slaney, Emma; McFarlane, Michael; Baker, Graham; Elnagar, Mohamed; Yuzari , Sarah; Gkoutos, George V.; Ghosh, Subrata; Iacucci, Marietta.

In: International journal of colorectal disease, Vol. 35, 02.2020, p. 285–293.

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Smith, Samuel ; Bazarova, Alina ; Ejenavi , Efe ; Qurashi, Maria ; Shivaji, Uday ; Harvey , Phil R ; Slaney, Emma ; McFarlane, Michael ; Baker, Graham ; Elnagar, Mohamed ; Yuzari , Sarah ; Gkoutos, George V. ; Ghosh, Subrata ; Iacucci, Marietta. / A multicentre development and validation study of a novel Lower Gastrointestinal Bleeding score-The Birmingham Score. In: International journal of colorectal disease. 2020 ; Vol. 35. pp. 285–293.

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@article{3a94aa45c23a4479ad1a7f935bfa69ca,
title = "A multicentre development and validation study of a novel Lower Gastrointestinal Bleeding score-The Birmingham Score",
abstract = "Purpose: Lower gastrointestinal bleeding (LGIB) is common and risk stratification scores can guide clinical decision-making. There is no robust risk stratification tool specific for LGIB, with existing tools not routinely adopted. We aimed to develop and validate a risk stratification tool for LGIB.Methods:Retrospective review of LGIB admissions to three centres between 2010-2018 formed the derivation cohort. Using regressional analysis within a machine learning technique, risk factors for adverse outcomes were identified, forming a simple risk stratification score-The Birmingham Score. Retrospective review of an additional centre, not included in the derivation cohort, was performed to validate the score.Results: Data from 469 patients were included in the derivation cohort and 180 in the validation cohort. Admission haemoglobin OR 1.07(95% CI 1.06-1.08) and male gender OR 2.29(95% CI 1.40-3.77) predicted adverse outcomes in the derivation cohort AUC 0.86(95% CI 0.82-0.90) which outperformed the Blatchford 0.81(95% CI 0.77-0.85), Rockall 0.60(95% CI 0.55-0.65) and AIM65 0.55(0.50-0.60) scores and in the validation cohort AUC 0.80(95% CI 0.73-0.87) which outperformed the Blatchford 0.77(95% CI 0.70-0.85), Rockall 0.67(95% CI 0.59-0.75) and AIM 65 scores 0.61(95% CI 0.53-0.69). The Birmingham Score also performs well at predicting adverse outcomes from diverticular bleeding AUC 0.87 (95% CI 0.75-0.98). A score of 7 predicts a 94% probability of adverse outcome.Conclusion:The Birmingham Score represents a simple risk stratification score that can be used promptly on patients admitted with LGIB. ",
author = "Samuel Smith and Alina Bazarova and Efe Ejenavi and Maria Qurashi and Uday Shivaji and Harvey, {Phil R} and Emma Slaney and Michael McFarlane and Graham Baker and Mohamed Elnagar and Sarah Yuzari and Gkoutos, {George V.} and Subrata Ghosh and Marietta Iacucci",
year = "2020",
month = feb
doi = "10.1007/s00384-019-03459-z",
language = "English",
volume = "35",
pages = "285–293",
journal = "International journal of colorectal disease",
issn = "0179-1958",
publisher = "Springer",

}

RIS

TY - JOUR

T1 - A multicentre development and validation study of a novel Lower Gastrointestinal Bleeding score-The Birmingham Score

AU - Smith, Samuel

AU - Bazarova, Alina

AU - Ejenavi , Efe

AU - Qurashi, Maria

AU - Shivaji, Uday

AU - Harvey , Phil R

AU - Slaney, Emma

AU - McFarlane, Michael

AU - Baker, Graham

AU - Elnagar, Mohamed

AU - Yuzari , Sarah

AU - Gkoutos, George V.

AU - Ghosh, Subrata

AU - Iacucci, Marietta

PY - 2020/2

Y1 - 2020/2

N2 - Purpose: Lower gastrointestinal bleeding (LGIB) is common and risk stratification scores can guide clinical decision-making. There is no robust risk stratification tool specific for LGIB, with existing tools not routinely adopted. We aimed to develop and validate a risk stratification tool for LGIB.Methods:Retrospective review of LGIB admissions to three centres between 2010-2018 formed the derivation cohort. Using regressional analysis within a machine learning technique, risk factors for adverse outcomes were identified, forming a simple risk stratification score-The Birmingham Score. Retrospective review of an additional centre, not included in the derivation cohort, was performed to validate the score.Results: Data from 469 patients were included in the derivation cohort and 180 in the validation cohort. Admission haemoglobin OR 1.07(95% CI 1.06-1.08) and male gender OR 2.29(95% CI 1.40-3.77) predicted adverse outcomes in the derivation cohort AUC 0.86(95% CI 0.82-0.90) which outperformed the Blatchford 0.81(95% CI 0.77-0.85), Rockall 0.60(95% CI 0.55-0.65) and AIM65 0.55(0.50-0.60) scores and in the validation cohort AUC 0.80(95% CI 0.73-0.87) which outperformed the Blatchford 0.77(95% CI 0.70-0.85), Rockall 0.67(95% CI 0.59-0.75) and AIM 65 scores 0.61(95% CI 0.53-0.69). The Birmingham Score also performs well at predicting adverse outcomes from diverticular bleeding AUC 0.87 (95% CI 0.75-0.98). A score of 7 predicts a 94% probability of adverse outcome.Conclusion:The Birmingham Score represents a simple risk stratification score that can be used promptly on patients admitted with LGIB.

AB - Purpose: Lower gastrointestinal bleeding (LGIB) is common and risk stratification scores can guide clinical decision-making. There is no robust risk stratification tool specific for LGIB, with existing tools not routinely adopted. We aimed to develop and validate a risk stratification tool for LGIB.Methods:Retrospective review of LGIB admissions to three centres between 2010-2018 formed the derivation cohort. Using regressional analysis within a machine learning technique, risk factors for adverse outcomes were identified, forming a simple risk stratification score-The Birmingham Score. Retrospective review of an additional centre, not included in the derivation cohort, was performed to validate the score.Results: Data from 469 patients were included in the derivation cohort and 180 in the validation cohort. Admission haemoglobin OR 1.07(95% CI 1.06-1.08) and male gender OR 2.29(95% CI 1.40-3.77) predicted adverse outcomes in the derivation cohort AUC 0.86(95% CI 0.82-0.90) which outperformed the Blatchford 0.81(95% CI 0.77-0.85), Rockall 0.60(95% CI 0.55-0.65) and AIM65 0.55(0.50-0.60) scores and in the validation cohort AUC 0.80(95% CI 0.73-0.87) which outperformed the Blatchford 0.77(95% CI 0.70-0.85), Rockall 0.67(95% CI 0.59-0.75) and AIM 65 scores 0.61(95% CI 0.53-0.69). The Birmingham Score also performs well at predicting adverse outcomes from diverticular bleeding AUC 0.87 (95% CI 0.75-0.98). A score of 7 predicts a 94% probability of adverse outcome.Conclusion:The Birmingham Score represents a simple risk stratification score that can be used promptly on patients admitted with LGIB.

U2 - 10.1007/s00384-019-03459-z

DO - 10.1007/s00384-019-03459-z

M3 - Article

VL - 35

SP - 285

EP - 293

JO - International journal of colorectal disease

JF - International journal of colorectal disease

SN - 0179-1958

ER -