In-Hospital Mortality in Patients With Lower Gastrointestinal Bleeding: Development and Validation of a Prediction Score

In-Hospital Mortality in Patients With Lower Gastrointestinal Bleeding: Development and Validation of a Prediction Score Publisher Pubmed

Dajti E^{1, 2} ; Frazzoni L³ ; Castelletfarrus S⁴ ; Guardiola J⁴ ; Sinagra E⁵ ; Anderloni A⁶ ; Ferrara F⁷ ; Gkolfakis P⁸ ; Camus Duboc M⁹ ; Mandarino FV¹⁰ ; Sadeghi A¹¹ ; Lorenzozuniga V¹² ; Perez S¹³ ; Triantafyllou K¹⁴ Show All Authors

Dajti E^{1, 2}
Frazzoni L³
Castelletfarrus S⁴
Guardiola J⁴
Sinagra E⁵
Anderloni A⁶
Ferrara F⁷
Gkolfakis P⁸
Camus Duboc M⁹
Mandarino FV¹⁰
Sadeghi A¹¹
Lorenzozuniga V¹²
Perez S¹³
Triantafyllou K¹⁴
Curado MP¹⁵
Facciorusso A¹⁶
Collatuzzo G²
Hassan C^{17, 18}
Radaelli F¹⁹
Fuccio L¹²

Show Affiliations

1. Gastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
2. Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
3. Gastroenterology and Digestive Endoscopy Unit, Forli-Cesena Hospitals, AUSL Romagna, Forli, Italy
4. Department of Gastroenterology, Hospital Bellvitge, L'Hospitalet, Barcelona, Spain
5. Gastroenterology and Endoscopy Unit, Fondazione Istituto S. Raffaele-G. Giglio, Cefalu, Italy
6. Gastroenterology and Digestive Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
7. Gastroenterology Unit, University Hospital of Padova, Padova, Italy
8. Department of Gastroenterology, Konstantopoulio-Patision General Hospital of Nea Ionia, Athens, Greece
9. Centre for Digestive Endoscopy, Sorbonne University, Saint-Antoine Hospital, APHP, Paris, France
10. Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Milan, Italy
11. Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
12. Endoscopy Unit, Hospital Universitari i Politecnic La Fe/IISLaFe, Valencia, Spain
13. Hospital Universitario Ramon y Cajal, Universidad de Alcala, IRYCIS, Madrid, Spain
14. Hepatogastroenterology Unit, Attikon University General Hospital, Athens, Greece
15. Colorectal Cancer Department, AC Camargo Cancer Center, Sao Paulo, Brazil
16. Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
17. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
18. IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
19. Gastroenterology Unit, Valduce Hospital, Como, Italy

Source: Endoscopy Published:2025

Abstract

Background Lower gastrointestinal bleeding (LGIB) is a common condition linked to increased morbidity, healthcare costs, and mortality. Currently, no prospectively validated prognostic model exists to predict mortality in patients with LGIB. Our aim was to develop and validate a risk score that could accurately predict in-hospital mortality of patients admitted for LGIB. Methods Patient data from a nationwide cohort study in 15 centers in Italy (2019-2020) were used to derive the risk score, the Acute Lower gastrointestinal Bleeding and In-hospital mortality (ALIBI) score; the model was then externally validated in a cohort of consecutive patients hospitalized for LGIB in 12 centers from six countries (Italy, Spain, France, Greece, Iran, and Brazil) from 2022 to 2024. The main outcome was in-hospital mortality; we also reported rebleeding rates and the in-hospital mortality rate stratified by risk score and timing of colonoscopy. Results Among 1198 patients in the derivation cohort, 105 (8.8%) re-bled and 41 (3.4%) died. Age, Charlson Co-morbidity Index, in-hospital onset, hemodynamic instability, and creatinine level were independent predictors of in-hospital mortality. The model demonstrated excellent discrimination (area under the receiver operating curve [AUROC] 0.81, 95%CI 0.75-0.87) and calibration. In the validation cohort (n = 752 patients), the model's good discrimination (AUROC 0.79, 95%CI 0.72-0.86) and calibration were confirmed. Patients were categorized as low (0-4 points; 1% mortality), intermediate (5-9 points; 4.6% mortality), or high risk (10-13 points; 19.1% mortality). Conclusion A new validated score effectively predicts in-hospital mortality in patients with LGIB, aiding in their risk stratification and management. © 2025. Thieme. All rights reserved.

2. Validity of the Models Predicting 10-Year Risk of Cardiovascular Diseases in Asia: A Systematic Review and Prediction Model Metaanalysis, PLoS ONE (2023)

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Style	Citing Format
MLA	Dajti E, et al.. "In-Hospital Mortality in Patients With Lower Gastrointestinal Bleeding: Development and Validation of a Prediction Score." Endoscopy, vol. , no. , 2025, pp. -.
APA	Dajti E, Frazzoni L, Castelletfarrus S, Guardiola J, Sinagra E, Anderloni A, Ferrara F, Gkolfakis P, Camus Duboc M, Mandarino FV, Sadeghi A, Lorenzozuniga V, Perez S, Triantafyllou K, Curado MP, Facciorusso A, Collatuzzo G, Hassan C, Radaelli F, Fuccio L (2025). In-Hospital Mortality in Patients With Lower Gastrointestinal Bleeding: Development and Validation of a Prediction Score. Endoscopy, (), -.
Chicago	Dajti E, Frazzoni L, Castelletfarrus S, Guardiola J, Sinagra E, Anderloni A, Ferrara F, et al.. "In-Hospital Mortality in Patients With Lower Gastrointestinal Bleeding: Development and Validation of a Prediction Score." Endoscopy , no. (2025): -.
Harvard	Dajti E et al. (2025) 'In-Hospital Mortality in Patients With Lower Gastrointestinal Bleeding: Development and Validation of a Prediction Score', Endoscopy, (), pp. -.
Vancouver	Dajti E, Frazzoni L, Castelletfarrus S, Guardiola J, Sinagra E, Anderloni A, et al.. In-Hospital Mortality in Patients With Lower Gastrointestinal Bleeding: Development and Validation of a Prediction Score. Endoscopy. 2025;():-.
BibTex	@article{ author = {Dajti E and Frazzoni L and Castelletfarrus S and Guardiola J and Sinagra E and Anderloni A and Ferrara F and Gkolfakis P and Camus Duboc M and Mandarino FV and Sadeghi A and Lorenzozuniga V and Perez S and Triantafyllou K and Curado MP and Facciorusso A and Collatuzzo G and Hassan C and Radaelli F and Fuccio L}, title = {In-Hospital Mortality in Patients With Lower Gastrointestinal Bleeding: Development and Validation of a Prediction Score}, journal = {Endoscopy}, volume = {}, number = {}, pages = {-}, year = {2025} }
RIS	TY - JOUR AU - Dajti E AU - Frazzoni L AU - Castelletfarrus S AU - Guardiola J AU - Sinagra E AU - Anderloni A AU - Ferrara F AU - Gkolfakis P AU - Camus Duboc M AU - Mandarino FV AU - Sadeghi A AU - Lorenzozuniga V AU - Perez S AU - Triantafyllou K AU - Curado MP AU - Facciorusso A AU - Collatuzzo G AU - Hassan C AU - Radaelli F AU - Fuccio L TI - In-Hospital Mortality in Patients With Lower Gastrointestinal Bleeding: Development and Validation of a Prediction Score JO - Endoscopy VL - IS - SP - EP - PY - 2025 ER -

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