A180 SENSITIVITY AND SPECIFICITY OF LOWER GASTROINTESTINAL BLEEDING SCORES TO PREDICT ADVERSE OUTCOMES: SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Abstract Background Acute lower gastrointestinal bleeding (LGIB) is a common reason for emergency hospitalization. In most patients bleeding resolves spontaneously, although some presentations result in adverse outcome such as transfusion, therapeutic intervention, rebleeding and mortality. Risk prediction scores are important to stratify patients at presentation with LGIB. Aims To perform a systematic review and meta-analysis comparing LGIB risk prediction scores. We provide a summary effect measure of their predictive values for 30-day mortality, safe discharge, rebleeding, need for blood transfusion, and need for endoscopic therapy/IR/surgery. Methods Electronic search for relevant publications after 1990 was conducted in PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, NIH ClinicalTrials.gov, and Cochrane Database of Systematic Reviews. We also searched relevant published conference abstracts over the past 5 years. Studies with a primary goal of deriving or validating a LGIB risk score were included. Title and abstracts were reviewed by two independent reviewers and then full text review was done by both reviewers. Results Our search identified 1,832 citations for review. After title and abstract review, 68 publications were selected for full text review. So far, a total of 16 citations were excluded since we started full text review including: insufficient information (n=14), review article (n=2). Thus far, we identified 14 risk scores and algorithms from 9 studies. Two of the risk scores are UGIB risk scores that were assessed for LGIB. Of these studies, 3 were validation studies, one derivation study and five for both validation and derivation. The scores assessed safety of discharge (n=3), mortality (n=4), need for therapy (n=8), severe bleeding (n=8) and requirement for blood transfusion (n=1). A meta-analysis will follow. Conclusions We conducted a systematic review of LGIB risk scores, with a meta-analysis to follow if appropriate, for use to predict 30-day mortality, safe discharge, rebleeding, required blood transfusion, endoscopic therapy/IR/surgery. Funding Agencies None