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ABC score is an effective predictor of outcomes in peptic ulcer bleeding
Heon Sakong1, Hee Seok Moon, Seong Woo Choi
1Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, South Korea.
Insights
The ABC score accurately predicts 30-day mortality in patients with peptic ulcer bleeding. However, it is less effective for predicting rebleeding or the need for interventions.
Area of Science:
- Gastroenterology
- Clinical Risk Stratification
- Medical Outcomes Research
Background:
- Risk stratification is crucial for patients experiencing gastrointestinal (GI) bleeding.
- The ABC score demonstrates high accuracy in assessing both upper and lower GI bleeding risks.
- Peptic ulcer bleeding necessitates effective outcome prediction tools.
Purpose of the Study:
- To evaluate the efficacy of the ABC score in predicting outcomes for patients with peptic ulcer bleeding.
- To compare the predictive performance of the ABC score against other established scoring systems.
Main Methods:
- A retrospective study involving 772 patients diagnosed with peptic ulcer bleeding.
- Analysis of associations between ABC score variables and patient outcomes.
- Validation of the ABC score's predictive performance using receiver-operating characteristic (ROC) curve analysis.
Main Results:
- The ABC score accurately predicted 30-day mortality (AUROC 0.927).
- Key predictors for mortality included age, serum albumin, serum creatinine, mental status, and ASA score.
- The ABC score showed lower accuracy in predicting rebleeding (AUROC 0.630) and need for intervention (AUROC 0.641).
Conclusions:
- The ABC score is a reliable tool for predicting 30-day mortality in peptic ulcer bleeding patients.
- The ABC score's utility may be limited in predicting rebleeding or the need for radiologic/surgical interventions.
Background:
Risk stratification is recommended for patients with gastrointestinal (GI) bleeding. The ABC score is a new scoring tool with high accuracy for upper and lower GI bleeding. We aimed to evaluate the effectiveness of the ABC score in predicting the outcomes of patients with peptic ulcer bleeding.
Methods:
This single-center retrospective study included 809 patients, each with symptoms of upper GI bleeding, and who were diagnosed with ulcerative lesions between October 2011 and March 2021. The association between the ABC score's variables and the patients' outcome was analyzed. The score's performance in predicting the patients' outcome was validated using receiver-operating characteristic curve analysis and compared with that of other scores.
Results:
The study analyzed 772 patients with peptic ulcer bleeding. The primary outcome measure was all-cause 30-day mortality. Secondary outcome measures included rebleeding within 30 days and the need for radiologic/surgical intervention. Age (P = .013), serum albumin levels (P < .001), serum creatinine levels (P = .004), mental status (P < .001), and American Society of Anesthesiologists score (P < .001) were associated with the primary outcome. The ABC score predicted the 30-day mortality (area under the receiver-operating characteristic curve [AUROC] 0.927; 95% confidence interval [CI] 0.899-0.956) better than other scores. However, it was less accurate in predicting rebleeding (AUROC 0.630; 95% CI 0.563-0.697) and need for radiologic/surgical intervention (AUROC 0.641; 95% CI 0.550-0.732).
Conclusions:
The ABC score accurately predicts the 30-day mortality in patients with peptic ulcer bleeding. However, it may not be suitable for predicting rebleeding or the need for radiologic/surgical interventions.
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