Gastrointestinal Bleeding in Patients Admitted to Cardiology: risk factors and  a new risk score

Abstract Background: Although the early use of a risk stratification score in gastrointestinal bleeding(GIB) is recommended, there has been no risk score for GIB in patients admitted to cardiology so far.Objective:To describe the risk factors of GIB and develop a new risk score model in patients admitted to cardiology. Methods: A total of 633 inpatients with GIB from January 2014 to December 2018 were recruited, 4,231 inpatients with non-GIB recruited as the control group. Multivariate logistic regression was used to describe the risk factors of GIB,A new risk score model was developed in the derivation cohort. Accuracy to predict GIB was assessed by the area under the receiver operating characteristic (AUROC) curve in the validation cohort.Results: Male, coronary heart disease, hypertension, stroke, systolic blood pressure, hematocrit, plasma albumin and alanine aminotransferase(ALT) were associated with GIB . The model had a high predictive accuracy (AUROC 0.816; 95%CI, 0.792-0.839), which was supported by the validation cohort (AUROC 0.841; 95% CI, 0.807~0.874). Besides,the prediction of the model better than HAS-BLED score(AUROC 0.557; 95%CI, 0.513~0.602) and CRUSADE score(AUROC 0.791; 95%CI, 0.757~0.825), respectively. Among the inpatients with a score 0-3, 4-7, and ≥8 points, the incidence of GIB, the proportion of inpatients requiring suspended red blood cells transfusion, length of stay and in-hospital mortality all increased gradually(P< 0.001). Conclusions: Male, coronary heart disease, hypertension, stroke, systolic blood pressure, hematocrit, plasma albumin and ALT are associated with GIB. The new risk score model is an accurate risk score that predicts GIB in patients admitted to cardiology.