RHEMITT Score: Predicting the Risk of Rebleeding for Patients with Mid-Gastrointestinal Bleeding Submitted to Small Bowel Capsule Endoscopy

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Magalhaes, RD (Author) Other; Goncalves, TC (Author) Other; Rosa, B (Author) Other; Moreira, MJ (Author) Other; Sousa Pinto, B (Author) FMUP; Cotter, J (Author) Other

Journal

Title: Digestive Diseases

Vol. 38

Pages: 299-309

ISSN: 0257-2753

Publisher: Karger

Indexing

ISI Web of Knowledge - 15 Citations

Scopus - 15 Citations

Other information

Authenticus ID: P-00R-EHD

DOI: 10.1159/000504385

Abstract (EN): Introduction:Small bowel capsule endoscopy (SBCE) is the gold standard for mid-gastrointestinal bleeding (MGIB). No score has been developed to predict the risk of small bowel rebleeding after SBCE.Objective:Creating a predictive small bowel rebleeding risk score for MGIB, after initial SBCE.Methods:Retrospective, single center study, including SBCEs for MGIB, from June 2006 to October 2016. The minimum follow-up was 12 months. Univariate analysis and a multivariable Cox regression model tested the association with rebleeding. Statistically significant variables were used to compute the score. The score's accuracy was tested through a receiver operating characteristic (ROC) curve. A classification tree identified risk groups. For internal validation, we performed a 5-fold cross validation.Results:We assessed 357 SBCEs for MGIB, of which 88 (24.6%) presented rebleeding during follow-up. Seven variables were used to compute a risk-predicting score - the RHEMITT score - namely, renal disease; heart failure; endoscopic capsule P1/P2 lesions; major bleeding; incomplete capsule; tobacco consumption; and endoscopic treatment. The score presented good accuracy toward the outcome (area under the curve ROC 0.842, 95% CI 0.757-0.927). We established 3 rebleeding risk groups: low (0-3 points); intermediate (4-10 points); and high (+11 points).Conclusion:A new MGIB score, named RHEMITT, accurately anticipates the individual risk of small bowel rebleeding after initial SBCE.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 11