{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T11:49:12Z","timestamp":1769168952403,"version":"3.49.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,2]]},"abstract":"\n BACKGROUND:<\/jats:title>\n Acute lower gastrointestinal bleeding is a common cause of hospital admission. NOBLADS is a lower gastrointestinal bleeding clinical risk score.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE:<\/jats:title>\n This study aimed to externally validate NOBLADS in predicting severe acute lower gastrointestinal bleeding and clinical outcome.<\/jats:p>\n <\/jats:sec>\n \n DESIGN:<\/jats:title>\n Observational retrospective study.<\/jats:p>\n <\/jats:sec>\n \n SETTING:<\/jats:title>\n This study was performed in a single large tertiary hospital.<\/jats:p>\n <\/jats:sec>\n \n PATIENTS:<\/jats:title>\n Patients who were admitted with acute lower gastrointestinal bleeding during a 15-month period and underwent endoscopic evaluation were included. Patients with chronic lower gastrointestinal bleeding or acute lower gastrointestinal bleeding who were admitted for other conditions were excluded.<\/jats:p>\n <\/jats:sec>\n \n MAIN OUTCOME MEASURES:<\/jats:title>\n Primary outcome was acute severe lower gastrointestinal bleeding (classified as severe if requires transfusion of >2 units of packed red blood cells and\/or produces a >20% hematocrit fall). Secondary outcomes: red blood cells requirement, therapeutic intervention and hospital stay duration. NOBLADS score was applied to all patients. Its accuracy to predict acute severe bleeding and secondary outcomes were studied using receiver operating characteristic analysis.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n A total of 173 patients (50.3% males, age 69 \u00b1 17 years) were included. The most common lower gastrointestinal bleeding etiologies were diverticular bleeding (18.5%) and ischemic colitis (15.6%). Fifty patients (28.9%) presented criteria for severe bleeding and 33 patients required instrumental intervention: endoscopic (n = 28), surgical (n = 4), and radiologic (n = 1) therapy. NOBLADS score was significantly different according with acute lower gastrointestinal bleeding causes (p<\/jats:italic> < 0.001) and accurately predicted severe bleeding (area under the receiver operating characteristic curve 0.923 \u00b1 0.018 (p<\/jats:italic> < 0.001)). NOBLADS \u22652 detected acute severe lower gastrointestinal bleeding with 100% sensitivity\/62.4% specificity, identifying the need for higher red blood cells requirement (3.6 vs 0.08, p<\/jats:italic> < 0.001), therapeutic intervention (38% vs 13%, p<\/jats:italic> < 0.001), and longer hospital stay (12.8 vs 3 days, p<\/jats:italic> < 0.001).<\/jats:p>\n <\/jats:sec>\n \n LIMITATIONS:<\/jats:title>\n Unicenter retrospective study; number of unprepared sigmoidoscopies\/left side colonoscopies; comparison between NOBLADS and other scoring systems was not performed.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION:<\/jats:title>\n NOBLADS is a practical, highly accurate tool and predicts the need of in-hospital management, early colonoscopy, red blood cells transfusion, and longer hospital stay in patients admitted with acute lower gastrointestinal bleeding. See Video Abstract<\/jats:bold> at http:\/\/links.lww.com\/DCR\/B748.<\/jats:p>\n \n NOBLADS: VALIDACI\u00d3N EXTERNA DE UN SISTEMA DE PUNTUACI\u00d3N DE RIESGO PARA HEMORRAGIA DIGESTIVA BAJA AGUDA GRAVE<\/jats:bold>\n <\/jats:p>\n <\/jats:sec>\n \n ANTECEDENTES:<\/jats:title>\n La hemorragia digestiva baja aguda es causa com\u00fan de admisi\u00f3n hospitalaria. NOBLADS es una puntuaci\u00f3n de riesgo cl\u00ednico de hemorragia gastrointestinal baja.<\/jats:p>\n <\/jats:sec>\n \n OBJETIVO:<\/jats:title>\n Este estudio tuvo como objetivo validar externamente NOBLADS en la predicci\u00f3n de hemorragia digestiva baja aguda grave y sus resultados cl\u00ednicos.<\/jats:p>\n <\/jats:sec>\n \n DISE\u00d1O:<\/jats:title>\n Estudio observacional retrospectivo.<\/jats:p>\n <\/jats:sec>\n \n AJUSTE:<\/jats:title>\n Realizado en un gran hospital terciario.<\/jats:p>\n <\/jats:sec>\n \n PACIENTES:<\/jats:title>\n Se incluyeron todas aquellas personas ingresados con hemorragia digestiva baja aguda durante un per\u00edodo de 15 meses y que fueron sometidos a evaluaci\u00f3n endosc\u00f3pica. Se excluy\u00f3 la hemorragia digestiva baja cr\u00f3nica o la hemorragia digestiva baja aguda en pacientes ingresados por otras afecciones.<\/jats:p>\n <\/jats:sec>\n \n PRINCIPALES MEDIDAS DE RESULTADO:<\/jats:title>\n El resultado pricipal fue la hemorragia digestiva baja grave aguda (clasificada como grave si requiere >2 transfusiones de gl\u00f3bulos rojos y \/ o produce una ca\u00edda del hematocrit >20%). Las medidas de resultados secundarias fueron: requerimiento de gl\u00f3bulos rojos, intervenci\u00f3n terap\u00e9utica y duraci\u00f3n de la estancia hospitalaria. Se aplic\u00f3 la puntuaci\u00f3n NOBLADS a todos los pacientes. Se estudi\u00f3 su precisi\u00f3n para predecir la hemorragia aguda grave y los resultados secundarios mediante an\u00e1lisis ROC.<\/jats:p>\n <\/jats:sec>\n \n RESULTADOS:<\/jats:title>\n Se incluyeron 173 pacientes (50,3% varones, edad 69 \u00b1 17 a\u00f1os). La etiolog\u00eda de hemorragia digestiva baja m\u00e1s frecuentes fueron: la hemorragia de or\u00edgen diverticular (18,5%) y la colitis isqu\u00e9mica (15,6%). 50 pacientes (28,9%) presentaron criterios de sangrado severo y 33 pacientes requirieron intervenci\u00f3n instrumental: terapia endosc\u00f3pica (n<\/jats:italic> = 28), quir\u00fargica (n<\/jats:italic> = 4), radiol\u00f3gica (n<\/jats:italic> = 1). La puntuaci\u00f3n NOBLADS fue significativamente diferente seg\u00fan las causas de hemorragia digestiva baja aguda (p<\/jats:italic> <0,001), siendo precisa para predecir hemorragia grave (AUC 0,923 \u00b1 0,018 (p<\/jats:italic> <0,001). NOBLADS \u22652 detect\u00f3 hemorragia digestiva baja aguda grave con 100% de sensibilidad \/ 62,4 % de especificidad, identificando la necesidad de mayor requerimiento de gl\u00f3bulos rojos (3.6 vs 0.08, p<\/jats:italic> <0.001), intervenci\u00f3n terap\u00e9utica (38% vs 13%, p<\/jats:italic> <0.001) y estad\u00eda hospitalaria m\u00e1s prolongada (12.8 vs 3 d\u00edas, p<\/jats:italic> <0.001).<\/jats:p>\n <\/jats:sec>\n \n LIMITACIONES:<\/jats:title>\n Estudio retrospectivo Unicentrico; n\u00famero de sigmoidoscopias \/ colonoscopias del lado izquierdo no preparadas; no se realiz\u00f3 comparaci\u00f3n entre NOBLADS y otros sistemas de puntuaci\u00f3n.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSI\u00d3N:<\/jats:title>\n NOBLADS es una herramienta pr\u00e1ctica y altamente precisa que predice la necesidad de manejo hospitalario, colonoscopia precoz, transfusi\u00f3n de gl\u00f3bulos rojos y estad\u00eda hospitalaria m\u00e1s prolongada en pacientes ingresados con hemorragia digestiva baja aguda. Consulte Video Resumen<\/jats:bold> en http:\/\/links.lww.com\/DCR\/B748. (Traducci\u00f3n\u2014Dr. Xavier Delgadillo<\/jats:italic>)<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/dcr.0000000000002064","type":"journal-article","created":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T23:54:44Z","timestamp":1634169284000},"page":"264-270","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["NOBLADS\u2014External Validation of a Risk Scoring System for Severe Acute Lower Gastrointestinal Bleeding"],"prefix":"10.1097","volume":"65","author":[{"given":"Mariana","family":"Brito","sequence":"first","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal"},{"name":"PaMNEC - Grupo de Patologia M\u00e9dica, Nutri\u00e7\u00e3o e Exerc\u00edcio Cl\u00ednico, CiiEM, Centro de investiga\u00e7\u00e3o interdisciplinar Egas Moniz, Monte da Caparica, Portugal"}]},{"given":"Marta","family":"Patita","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal"}]},{"given":"Gon\u00e7alo","family":"Nunes","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal"},{"name":"PaMNEC - Grupo de Patologia M\u00e9dica, Nutri\u00e7\u00e3o e Exerc\u00edcio Cl\u00ednico, CiiEM, Centro de investiga\u00e7\u00e3o interdisciplinar Egas Moniz, Monte da Caparica, Portugal"}]},{"given":"Manuela","family":"Canhoto","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal"}]},{"given":"Jorge","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, Almada, Portugal"},{"name":"PaMNEC - Grupo de Patologia M\u00e9dica, Nutri\u00e7\u00e3o e Exerc\u00edcio Cl\u00ednico, CiiEM, Centro de investiga\u00e7\u00e3o interdisciplinar Egas Moniz, Monte da Caparica, Portugal"}]}],"member":"276","published-online":{"date-parts":[[2022,1,18]]},"reference":[{"key":"R1-20250505","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/gut.2006.117598","article-title":"Gastroenterology services in the UK. 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