Prediction of esophagogastroduodenoscopy therapeutic usefulness for in-ICU suspected upper gastrointestinal bleeding: the SUGIBI score study

International audienceBackground: Suspected upper gastrointestinal bleeding (SUGIB) is a common issue during ICU stay. In the absence of specific guidelines on the indication and timing of esophagogastroduodenoscopy (EGD), there is substantial variability in EGD indication depending on accessibility and clinical presentation. This study aimed to investigate factors associated with the need for per-EGD hemostatic therapy and to create a score predicting therapeutic benefit of emergency bedside EGD in ICU patients with SUGIB. Methods: We conducted a retrospective study in our ICU to identify factors associated with the need for hemostatic procedure during EGD performed for SUGIB. From this observational cohort, we derived a score predicting the need for hemostasis during EGD, the SUGIBI score. This score was subsequently validated in a retrospective multicenter cohort. Results: Two hundred fifty-five patients not primarily admitted for GI bleeding who underwent a bedside EGD for SUGIB during their ICU stay were analyzed. The preeminent EGD indication were anemia (79%), melena (19%), shock (14%), and hematemesis (13%). EGD was normal in 24.7% of cases, while primary lesions reported were ulcers (23.1%), esophagitis (18.8%), and gastritis (12.5%). Only 12.9% of patients underwent hemostatic endotherapy during EGD. A SUGIBI score Conclusions Our study shows that the therapeutic usefulness of bedside emergency EGD for SUGIB in critically ill patients is limited to a minority of patients. The SUGIBI score should help clinicians stratify the probability of a therapeutic EGD

Prevalence and determinants of fatigue in patients with IBD: a cross-sectional survey from the GETAID.

International audienceBackground: Fatigue is commonly reported by patients with inflammatory bowel disease (IBD), but the determinants of IBD-related fatigue have yet to be determined.Aims: To identify the factors associated with fatigue in a large population of patients with IBD.Patients and methods: Fatigue and nine other IBD-related disability dimensions were assessed in a cohort of 1704 consecutive patients with IBD using the IBD-disk questionnaire in a cross-sectional survey of 42 French and Belgian centers. Fatigue and severe fatigue were defined as energy subscores >5 and >7, respectively. Determinants of fatigue were assessed using univariate and multivariate analyses (odds ratios (ORs) are provided with 95% confidence intervals).Results: The prevalence rates of fatigue and severe fatigue were 54.1% and 37.1%, respectively. Both fatigue and severe fatigue were significantly higher in patients with active disease than in patients with inactive disease (64.9% vs. 44.7% and 47.4% vs. 28.6%, respectively; p40 years (OR=0.71 [0.54-0.93]), female sex (OR=1.48 [1.13-1.93]), IBD-related sick leave (OR=1.61 (1.19-2.16]), and joint pain (OR=1.60 [1.17-2.18]), abdominal pain (OR=1.78 [1.29-2.45]), regulating defecation (OR=1.67 [1.20-2.32]), education and work (OR=1.96 [1.40-2.75]), body image (OR=1.38 [1.02-1.86]), sleep (OR=3.60 [2.66-4.88]) and emotions (OR=3.60 [2.66-4.88]) subscores > 5.Conclusion: Determinants of fatigue are not restricted to IBD-related factors but also include social factors, sleep, and emotional disturbances, thus supporting a holistic approach to IBD patient care