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Validation of the new ABC score for predicting 30-day mortality in gastrointestinal bleeding
Marie Christelle Saade1, Anthony Kerbage1, Suha Jabak1
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Insights
The ABC score effectively predicts mortality in gastrointestinal bleeding (GIB) patients. This novel scoring system outperforms existing methods for both upper and lower GIB, aiding clinical decisions.
Area of Science:
- Gastroenterology
- Clinical Medicine
- Predictive Analytics
Background:
- Gastrointestinal bleeding (GIB) poses significant mortality risks.
- Accurate prediction of mortality is crucial for effective patient management.
- Existing scoring systems have limitations in predicting outcomes for both upper and lower GIB.
Purpose of the Study:
- To validate the novel ABC score for predicting one-month mortality in patients with upper and lower GIB.
- To compare the performance of the ABC score against established scores like Oakland, AIMS-65, and Rockall.
- To assess the utility of the ABC score in a Lebanese tertiary care center cohort.
Main Methods:
- Adult patients with overt GIB admitted to a tertiary care center were retrospectively analyzed.
- The ABC score's predictive performance for 30-day mortality was evaluated using Area Under the Receiver Operating Characteristic (AUROC) curves.
- The ABC score was compared with Oakland (lower GIB) and AIMS-65/Rockall (upper GIB) scores.
Main Results:
- The ABC score demonstrated good performance in predicting 30-day mortality for upper GIB (AUROC: 0.79), outperforming AIMS-65 (0.67) and Rockall (0.62).
- For lower GIB, the ABC score showed comparable performance to the Oakland score (AUROC: 0.70 vs 0.56).
- The ABC score proved superior or comparable to existing scores in this patient cohort.
Conclusions:
- The ABC score is a valuable tool for predicting 30-day mortality in patients with both upper and lower GIB.
- Its good performance and simplicity support its use in guiding clinical management decisions.
- The ABC score appears reproducible and applicable across different patient populations.
Background/Aim:
The ABC score is a new pre-endoscopic scoring system that was recently developed to accurately predict one-month mortality in upper and lower gastrointestinal bleeding (GIB). We aim to validate this new score on a cohort of Lebanese patients treated in a tertiary care center and to compare it to currently existing scores.
Methods:
Adult patients admitted to the American University of Beirut Medical Center (AUBMC) with overt GIB between January 2013 and August 2020 were included. The area under receiver operating characteristic (AUROC) curves of the ABC score in predicting 30-day mortality was calculated using the SPSS software. Other optimal existing scores for predicting mortality (the Oakland score for lower GIB, the AIMS-65 and the Rockall scores for upper GIB)s were also assessed and compared to the ABC score.
Results:
A total of 310 patients were included in our study. For upper GIB, the ABC score showed good performance in predicting 30-day mortality (AUROC: 0.79), outperforming both the AIMS-65 score (AUROC 0.67, p < 0.001) and the Rockall score (AUROC: 0.62, p < 0.001). For lower GIB, the ABC score also had good performance which was comparable to the Oakland score (AUROC: 0.70 vs 0.56, p = 0.26).
Conclusion:
In our cohort of patients, the ABC score demonstrated good performance in predicting 30-day mortality for patients with upper and lower GIB compared to other established risk scores, which may help guide management decisions. This simple and novel score provides valuable prognostic information for patients presenting with GIB and appears to be reproducible in different patient populations.
