ABC score is an effective predictor of outcomes in peptic ulcer bleeding

Abstract

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.

Are Short-Stay Units Safe and Effective in the Treatment of Non-Variceal Upper Gastrointestinal Bleeding?

“…Higher creatinine levels are associated with higher patient frailty and complexity, although the correlation with creatinine level remains after adjusting for these factors in this study. However, creatinine is an important risk factor for gastrointestinal bleeding and has been associated with increased mortality in several studies [ 14 , 15 , 16 ]. For this reason, the emergency physicians and endoscopists could be more motivated to request and perform early EGDS in these patients.…”

Risk Assessment in Non-Variceal Upper Gastrointestinal Bleeding: A Comprehensive Review of Scoring Systems

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