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Erschienen in: Digestive Diseases and Sciences 12/2018

14.08.2018 | Original Article

A Simple Pre-endoscopy Score for Predicting Risk of Malignancy in Patients with Dyspepsia: A 5-Year Prospective Study

verfasst von: Amit Kumar Dutta, Grace Rebekah, Sudipta Dhar Chowdhury, Sajith Kattiparambil Gangadharan, Yuvaraj Subramani, Manoj Kumar Sahu, Reuben Thomas Kurien, Deepu David, Ebby George Simon, Anjilivelil Joseph Joseph, Viswanath Reddy Donapati, Ashok Chacko

Erschienen in: Digestive Diseases and Sciences | Ausgabe 12/2018

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Abstract

Background

The guidelines for performing endoscopy in dyspeptic patients based on clinical parameters alone have shown variable performance, and there is a need for better prediction tools.

Aim

We aimed to prospectively develop and validate a simple clinical-cum-laboratory test-based scoring model to identify dyspeptic patients with high risk of upper gastrointestinal malignancy (UGIM).

Methods

Adult patients with dyspeptic symptoms were prospectively recruited over 5 years. Clinical details including alarm features were recorded, and blood tests for hemoglobin and albumin were done before endoscopy. The presence of UGIM was the primary outcome. Risk factors for UGIM were assessed, and based on the OR of significant factors, a predictive scoring model was constructed. ROC curve was plotted to identify optimal cutoff score. The model was validated using bootstrapping technique.

Results

The study included 2324 patients (41.9 ± 12.8 years; 33.4% females). UGIM was noted in 6.8% patients. The final model had following five positive predictors for UGIM—age > 40 years (OR 3.3, score 1); albumin ≤ 3.5 g% (OR 3.4, score 1); Hb ≤ 11 g% (OR 3.3, score 1); alarm features (OR 5.98, score 2); recent onset of symptoms (OR 8.7, score 3). ROC curve had an impressive AUC of 0.9 (0.88–0.93), and a score of 2 had 92.5% sensitivity in predicting UGIM. Validation by bootstrapping showed zero bias, which further strengthened our model.

Conclusion

This simple clinical-cum-laboratory test-based model performed very well in identifying dyspeptic patients at risk of UGIM. This can serve as a useful decision-making tool for referral for endoscopy.
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Metadaten
Titel
A Simple Pre-endoscopy Score for Predicting Risk of Malignancy in Patients with Dyspepsia: A 5-Year Prospective Study
verfasst von
Amit Kumar Dutta
Grace Rebekah
Sudipta Dhar Chowdhury
Sajith Kattiparambil Gangadharan
Yuvaraj Subramani
Manoj Kumar Sahu
Reuben Thomas Kurien
Deepu David
Ebby George Simon
Anjilivelil Joseph Joseph
Viswanath Reddy Donapati
Ashok Chacko
Publikationsdatum
14.08.2018
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 12/2018
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-018-5245-7

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