BEST-J score

Bleeding after ESD occurs in 4.1%8.5% of patients who undergo gastric ESD.
The BEST-J score is a prediction model to stratify the risk of bleeding after ESD for early gastric cancers.
Nine factors were weighted with point values: 4 points for anticoagulants (warfarin, direct oral anticoagulants), 3 points for chronic kidney disease with hemodialysis, 2 points each for P2Y12 receptor antagonist (thienopyridine) and aspirin, 1 point each for cilostazol, a tumor size >30 mm, lower-third in tumor location, and presence of multiple tumors, and 1 point for interruption of each kind of antithrombotic agents.
The patients were categorized into four bleeding risk groups: low (01 points: 2.8% risk), intermediate (2 points: 6.1%), high (34 points: 11.4%) and very high (5 points: 29.7%).

*1.
If an antiplatelet agent was replaced with another agent, select Temporal discontinuation of the original agent and None of the replaced agent.
For example, if P2Y12 receptor antagonist is replaced with aspirin, select Temporal discontinuation of P2Y12 receptor antagonist and None of aspirin.

*2.
If the patient received heparin bridging therapy, select Temporal discontinuation of the original agent.
For example, if warfarin is bridged with heparin, select Temporal discontinuation of warfarin.

*3.
Time of discontinuing antithrombotic agents before ESD is based on the Japanese guidelines (Dig Endosc.
2014; 26: 1-14.): aspirin, 35 days; P2Y12 receptor antagonist (thienopyridine), 57 days; cilostazol, 1 day; warfarin, 35 days; DOAC, 12 days.

For more information, see the reference below.

Gut.
2020 [Epub ahead of print]

A prediction model of bleeding after endoscopic submucosal dissection for early gastric cancer: BEST-J score.

Hatta W, Tsuji Y, Yoshio T, Kakushima N, Hoteya S, Doyama H, Nagami Y, Hikichi T, Kobayashi M, Morita Y, Sumiyoshi T, Iguchi M, Tomida H, Inoue T, Koike T, Mikami T, Hasatani K, Nishikawa J, Matsumura T, Nebiki H, Nakamatsu D, Ohnita K, Suzuki H, Ueyama H, Hayashi Y, Sugimoto M, Yamaguchi S, Michida T, Yada T, Asahina Y, Narasaka T, Kuribayashi S, Kiyotoki S, Mabe K, Nakamura T, Nakaya N, Fujishiro M, Masamune A.

You can view the application help by tapping a title bar.

DISCLAIMER: This application is intended for educational or research purposes only.
It does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.

[Developer]

2020

2020 Kenichi Negoro, MD, PhD

2020 Yoichi Kakuta, MD, PhD

2020 Waku Hatta, MD, PhD (Consultant)

2020 Xiaoyi Jin, MD, PhD (Translation)

http: //www.gastroente.med.tohoku.ac.jp/

[email protected],

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