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Huong Tu Lam,1 Thang Dinh Nguyen,2 Hoang Huu Bui,1 Thong Duy Vo1,3 1Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; 2Department of Gastroenterology, Cho Ray Hospital, Ho Chi Minh City, Vietnam; 3Department of Gastroenterology, University Medical Center Ho Chi Minh City, Ho Chi Minh City, VietnamCorrespondence: Thong Duy Vo, Department of Gastroenterology, University Medical Center Ho Chi Minh City, 215 Hong Bang, Ward 11, Dis. 5, Ho Chi Minh City, 72714, Vietnam, Tel +84 932039888, Email thong.vd@umc.edu.vnIntroduction: The Charlson Comorbidity Index ≥ 2, in-Hospital onset, Albumin < 2.5 g/dL, altered Mental status, Eastern Cooperative Oncology Group Performance status ≥ 2, Steroid use (CHAMPS) score is a novel and promising prognostic tool. We present an initial external validation of the CHAMPS score for predicting mortality in acute nonvariceal upper gastrointestinal bleeding (NVUGIB) across multiple clinical outcomes.Methods: A prospective cohort study was conducted on adult patients with NVUGIB admitted to the Department of Gastroenterology between November 2022 and June 2023. The CHAMPS score performance in predicting in-hospital outcomes was evaluated by employing area under the receiver operating characteristic (AUROC) curves, followed by a comparative analysis with five pre-existing scores.Results: A total of 140 patients were included in the study. The CHAMPS score showed its highest performance in predicting mortality rates (AUROC = 0.89), significantly outperforming the Glasgow-Blatchford Bleeding Score (GBS) as well as the Albumin level < 3.0 mg/dL, International normalized ratio > 1.5, altered Mental status, Systolic blood pressure ≤ 90 mmHg, and age > 65 years (AIMS65) score (AUROC = 0.72 and 0.71, respectively; all p < 0.05). Subgroup analysis for bleeding-related and non-bleeding-related mortality further confirmed the robust predictive capability of the CHAMPS score (AUROC = 0.88 and 0.87, respectively). The CHAMPS score failed to predict rebleeding and intervention reliably, exhibiting AUROC values of 0.43 and 0.55, respectively. The optimal CHAMPS score cutoff value for predicting mortality was 3 points, achieving 100% sensitivity and 71.2% specificity. In the low-risk category defined by both CHAMPS and GBS scores, mortality and rebleeding rates were 0%. However, within the CHAMPS score-based low-risk group, 58.8% required intervention, contrasting with a 0% intervention rate for the GBS score-based low-risk group (GBS score ≤ 1).Conclusion: The CHAMPS score consistently demonstrated a robust predictive performance for mortality (AUROC > 0.8), facilitating the identification of high-risk patients requiring aggressive treatment and low-risk patients in need of localized treatment or safe discharge after successful bleeding control.Keywords: non-variceal upper gastrointestinal bleeding, CHAMPS, mortality prediction, risk scores, GBS

Purpose: Eosinophilic gastrointestinal diseases represent a rare and diverse group of conditions. Given that the pathogenesis of EoC is not well understood and is often linked to allergic conditions, this case underscores the necessity for further research into such unique presentations. The patient's prolonged gastrointestinal symptoms presented a significant diagnostic challenge, emphasizing the importance of ruling out various potential causes for elevated blood eosinophils. This exploration aims to enhance the understanding of such rare clinical scenarios and improve diagnostic accuracy in similar cases., Case Description: We present a unique case of a 57-year-old patient with a medical history of asthma and allergic rhinitis who presented recurrent abdominal pain, significant blood eosinophilia, and elevated levels of Immunoglobulin G4. After ruling out hematological and secondary causes of eosinophilia, a biopsy of the colon mucosa revealed an excess of tissue eosinophils, confirming the diagnosis of EoC. The patient responded well to corticosteroids and was subsequently maintained on montelukast, with no recurrence of symptoms over 3 months., Conclusion: This rare confluence of EoC, asthma, and high levels of serum IgG4 in a single patient contributes to our understanding of these complex and interconnected disorders., Competing Interests: Qui Huu Nguyen and Tram Que Nguyen Pham are co-first authors. The authors declare they have no competing interest for this study., (© 2024 Nguyen et al.)