S670 The Glasgow Blatchford Score (GBS) Is Associated With the Need for Endoscopic Intervention and Blood Transfusion in Patients With Upper Gastrointestinal Bleeding
Bibliographic record
Abstract
Introduction: At an incidence of 48-160/100,000 individuals, upper gastrointestinal bleeding (UGIB) is the most common gastroenterological emergency, in the United States, accounting for 300,000 hospitalizations and $3.3 billion in healthcare spending, yearly. GBS, a quick tool that uses non-endoscopic criteria for clinical stratification of UGIB, allows for early diagnosis and outcome prediction, including need for intervention. The goals of this study are to determine the GBS scores of patients who underwent esophagogastroduodenoscopy (EGD) and if the need for endoscopic intervention and blood transfusion are related to GBS in patients with UGIB. Methods: This is a cross-sectional retrospective study that included patients ≥18 years, who were admitted for UGIB to McLaren Macomb Medical Center (MMMC) and underwent EGD between July, 2018 and July, 2020. The patient encounters of interest were identified using international classification of disease (ICD 10) procedure codes for EGD. Demographics and the need for intervention or blood transfusion, variables comprising GBS, and other explanatory variables were extracted. Frequencies, percentages, and student T-test were used when appropriate. A stepwise regression analysis was performed to determine predictors of GBS. SPSS version 25 was used to analyze the data. Statistical significance was set at a p< 0.05. Results: A total of 130 observations were included in this analysis. No patients were noted to have a GBS ≤2, indicating successful evidence-based allocation of resources, as a GBS ≤1 to ≤2 is associated with safe outpatient management. We found that GBS was statistically significantly related to the need for intervention, blood transfusion, and age group. Additionally, those who needed intervention and blood transfusion scored 1.493 [mean GBS 13.13±3.28 versus 10.62±3.83 (P=0.004)] and 3.486 [mean GBS 13.12±2.68 versus 9.16±3.83 (P=0.000)] higher, respectively. Also, those who are ≤60 years-old scored 1.77 [mean GBS 9.38±4.11 versus 11.7±3.57 (P=0.002)] less. Conclusion: Our study is among a few that investigated and found a mean GBS associated with need for intervention and blood transfusion. Even at higher GBS, we may be able to further stratify patients’ risk and predict need for intervention and blood transfusion. Further research is needed to investigate this nuance.Table 1.: Study Methodology Quality Assessment on Newcastle-Ottawa Scale.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".