Related Experiment Video
Updated: Dec 13, 2025
Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis
Published on: June 30, 2023
ABC score: a new risk score that accurately predicts mortality in acute upper and lower gastrointestinal bleeding: an
Stig Borbjerg Laursen1,2, Kathryn Oakland3, Loren Laine4
1Department of Medical Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark stig.laursen@rsyd.dk.
Insights
A new Age, Blood tests, and Comorbidities (ABC) score accurately predicts mortality in upper and lower gastrointestinal bleeding (UGIB and LGIB). This score aids in early risk stratification for better patient management.
Area of Science:
- Gastroenterology
- Clinical Medicine
- Predictive Analytics
Background:
- Existing mortality prediction scores for upper (UGIB) and lower (LGIB) gastrointestinal bleeding lack accuracy.
- There is a need for a reliable pre-endoscopy score to stratify mortality risk in patients with GI bleeding.
Purpose of the Study:
- To develop and validate a novel pre-endoscopy score for predicting mortality in both UGIB and LGIB.
- To compare the performance of the new score against existing risk stratification tools.
Main Methods:
- A retrospective international cohort study involving over 5,300 patients with UGIB and LGIB.
- Development of the Age, Blood tests, and Comorbidities (ABC) score using regression analyses in a UGIB cohort.
- External validation of the ABC score in independent UGIB and LGIB cohorts, comparing it with existing scores using AUROCs, sensitivity, and specificity.
Main Results:
- The ABC score demonstrated superior performance in predicting mortality for both UGIB and LGIB (AUROCs: 0.81-0.84) compared to existing scores (AUROCs: 0.65-0.75).
- In UGIB, 30-day mortality rates for low, medium, and high ABC scores were 1.0%, 7.0%, and 25%, respectively.
- In LGIB, in-hospital mortality rates for low, medium, and high ABC scores were 0.6%, 6.3%, and 18%, respectively, with significantly lower mortality in low-risk patients identified by ABC score compared to AIMS65.
Conclusions:
- The ABC score is a robust tool for predicting mortality in both UGIB and LGIB.
- This score facilitates early identification and targeted management of patients at high or low risk of death.
- The ABC score offers improved accuracy over previous scoring systems for gastrointestinal bleeding mortality prediction.
Objectives:
Existing scores are not accurate at predicting mortality in upper (UGIB) and lower (LGIB) gastrointestinal bleeding. We aimed to develop and validate a new pre-endoscopy score for predicting mortality in both UGIB and LGIB.
Design And Setting:
International cohort study. Patients presenting to hospital with UGIB at six international centres were used to develop a risk score for predicting mortality using regression analyses. The score's performance in UGIB and LGIB was externally validated and compared with existing scores using four international datasets. We calculated areas under receiver operating characteristics curves (AUROCs), sensitivities, specificities and outcome among patients classified as low risk and high risk.
Participants And Results:
We included 3012 UGIB patients in the development cohort, and 4019 UGIB and 2336 LGIB patients in the validation cohorts. Age, Blood tests and Comorbidities (ABC) score was closer associated with mortality in UGIB and LGIB (AUROCs: 0.81-84) than existing scores (AUROCs: 0.65-0.75; p≤0.02). In UGIB, patients with low ABC score (≤3), medium ABC score (4-7) and high ABC score (≥8) had 30-day mortality rates of 1.0%, 7.0% and 25%, respectively. Patients classified low risk using ABC score had lower mortality than those classified low risk with AIMS65 (threshold ≤1) (1.0 vs 4.5%; p<0.001). In LGIB, patients with low, medium and high ABC scores had in-hospital mortality rates of 0.6%, 6.3% and 18%, respectively.
Conclusions:
In contrast to previous scores, ABC score has good performance for predicting mortality in both UGIB and LGIB, allowing early identification and targeted management of patients at high or low risk of death.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
01:30Acute Coronary Syndrome I: Introduction
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:17Assessment of the Gastrointestinal System I: Subjective Data
Health History
The initial step in assessing the GI system is obtaining a comprehensive health history. This includes inquiring about the patient's history or presence of problems...