MAP(ASH): A new scoring system for the prediction of intervention and mortality in upper gastrointestinal bleeding

Background and Aim Risk stratification for upper gastrointestinal bleeding (UGIB) is recommended. However, scoring system accuracy is suboptimal, and score calculation can be complex. Our aim was to develop a new score, the MAP(ASH) score, with information available in the emergency room and to vali...

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Bibliographic Details
Published in:Journal of gastroenterology and hepatology 2020-01, Vol.35 (1), p.82-89
Main Authors: Redondo‐Cerezo, Eduardo, Vadillo‐Calles, Francisco, Stanley, Adrian J, Laursen, Stig, Laine, Loren, Dalton, Harry R, Ngu, Jing H, Schultz, Michael, Jiménez‐Rosales, Rita
Format: Article
Language:English
Subjects:
Accuracy
Admission Rockall score
AIMS65
Bleeding
Blood pressure
Blood transfusion
Emergency medical care
Endoscopy
Glasgow Blatchford score
Hemoglobin
MAP(ASH) score
Mortality
Patients
Surgery
Upper gastrointestinal bleeding
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Summary:Background and Aim Risk stratification for upper gastrointestinal bleeding (UGIB) is recommended. However, scoring system accuracy is suboptimal, and score calculation can be complex. Our aim was to develop a new score, the MAP(ASH) score, with information available in the emergency room and to validate it. Methods The score was built from a prospective database of patients with UGIB and validated in an international database of 3012 patients from six hospitals. Outcomes were 30‐day mortality, endoscopic intervention, any intervention (red blood transfusion, endoscopic treatment, interventional radiology, surgery, or death), and rebleeding. Accuracy to predict outcomes was assessed by the area under the receiver operating characteristic curve (AUROC). Results Five hundred forty‐seven patients were included in the development cohort. Impaired mental status, albumin  100, American Society of Anesthesiologists score > 2, systolic blood pressure 
ISSN:0815-9319
1440-1746
DOI:10.1111/jgh.14811