A Comparative Analysis of Risk Scoring Systems in Predicting Clinical Outcomes in Upper Gastrointestinal Bleed

Area of Science:

• Gastroenterology
• Clinical Medicine
• Medical Informatics

Background:

• Upper gastrointestinal bleeding (UGIB) is a critical medical emergency with varied presentations.
• Accurate risk stratification is vital for effective UGIB management and patient triage.
• Existing scoring systems aim to predict outcomes but require comparative analysis.

Purpose of the Study:

• To evaluate and compare the sensitivity and specificity of four UGIB risk scoring systems.
• To determine optimal cut-off values for these scores in predicting clinical outcomes.
• To identify the most effective scoring system for stratifying UGIB patients.

Main Methods:

• A prospective cross-sectional study involving 81 patients with acute UGIB.
• Utilized four scoring systems: Glasgow-Blatchford score (GBS), AIMS65, pre-endoscopic Rockall, and full Rockall.
• Assessed predictive accuracy for mortality, ICU admission, need for transfusion, and endoscopic intervention.

Main Results:

• AIMS65 and pre-Rockall scores demonstrated high accuracy (AUROC 0.91) in predicting mortality.
• GBS and AIMS65 showed utility in predicting the need for intensive care unit (ICU) admission.
• GBS proved superior in categorizing patients into high/low-risk groups and predicting interventions.

Conclusions:

• The Glasgow-Blatchford score (GBS) is highly effective for risk stratification and predicting interventions in UGIB.
• AIMS65 and pre-Rockall scores are comparable and reliable for predicting mortality in UGIB patients.
• Risk stratification using validated scores is crucial for optimizing UGIB patient management.