External validation and optimization of the Limoges score to improve the delayed bleeding risk prediction after colorectal endoscopic submucosal dissection: the Delayed Bleeding ESD (DEBE) score - Pub
5 hours ago
- #colorectal surgery
- #endoscopic submucosal dissection
- #bleeding risk
- The study aimed to validate and update the Limoges Bleeding Score for predicting delayed bleeding risk after colorectal endoscopic submucosal dissection (ESD) in a Western setting.
- A new score called DEBE (Delayed Bleeding ESD) was developed, incorporating seven preprocedural variables: age ≥ 75 years, lesion size ≥ 50 mm, ASA classification III-IV, location in the rectum or proximal colon, anticoagulants, and antiplatelets.
- The DEBE score categorized patients into low-risk (3.9%) and medium-high-risk (14.2%) groups, showing acceptable discrimination (AUC 0.712) and adequate calibration.
- The DEBE score helps personalize bleeding risk assessment, identify patients needing prophylactic treatment, and define those requiring post-ESD monitoring.
- The study included 4767 ESDs, with a clinically significant delayed bleeding (CSDB) prevalence of 6.8%.