Comparing the performance of the ABC, AIMS65, GBS, and pRS scores in predicting 90-day mortality or rebleeding among emergency department patients with acute upper gastrointestinal bleeding: A prospective multicenter study

Abstract

Background and Objectives Acute upper gastrointestinal bleeding (UGIB) is a common problem that can cause significant morbidity and mortality. We aimed to compare the performance of the ABC score (ABC), the AIMS65 score (AIMS65), the Glasgow-Blatchford score (GBS), and the pre-endoscopic Rockall score (pRS) in predicting 90-day mortality or rebleeding among patients with acute UGIB. Methods This was a prospective multicenter study conducted at 20 tertiary hospitals in China. Data were collected between June 30, 2020 and February 10, 2021. An area under the receiver operating characteristic curve (AUC) analysis was used to compare the performance of the four scores in predicting 90-day mortality or rebleeding. Results Among the 1072 patients included during the study period, the overall 90-day mortality rate was 10.91% (117/1072) and the rebleeding rate was 12.03% (129/1072). In predicting 90-day mortality, the ABC and pRS scores performed better with an AUC of 0.722 (95% CI 0.675–0.768; P<0.001) and 0.711 (95% CI 0.663–0.757; P<0.001), respectively, compared to the AIMS-65 (AUC, 0.672; 95% CI, 0.624–0.721; P<0.001) and GBS (AUC, 0.624; 95% CI, 0.569–0.679; P<0.001) scores. In predicting rebleeding in 90 days, the AUC of all scores did not exceed 0.70. Conclusion In patients with acute UGIB, ABC and pRS performed better than AIMS-65 and GBS in predicting 90-day mortality. The performance of each score is not satisfactory in predicting rebleeding, however. Newer predictive models are needed to predict rebleeding after UGIB.

Nomogram for predicting rebleeding after initial endoscopic epinephrine injection monotherapy hemostasis in patients with peptic ulcer bleeding: a retrospective cohort study

“…Unlike other clinical trials and guidelines [ 20 , 21 ], our present study showed no significant differences in rebleeding in the use of NSAID (3.9% vs. 2.9%; p = 0.698) or antiplatelet (3.9% vs. 4.5%; p = 0.845) drugs; we think this may be due to the small sample size of the chosen groups. The use of the Glasgow Blatchford score and Rockall score in the prediction of rebleeding in PUB patients after endoscopy EI remains controversial in different studies [ 22 , 23 ]. Budimir et al [ 22 ] reported that the Glasgow Blatchford score better predicted overall rebleeding risk than the Rockall score.…”

“…Budimir et al [ 22 ] reported that the Glasgow Blatchford score better predicted overall rebleeding risk than the Rockall score. However, Liu et al [ 23 ] concluded that the Rockall and Glasgow Blatchford scores are equivalent in predicting the rebleeding of acute upper gastrointestinal bleeding. In our study, the Rockall score was an independent predictor of rebleeding, but the Glasgow Blatchford score still had a high efficacy (p < 0.001) in predicting rebleeding.…”

Peri-Ulcerative Mucosal Inflammation Appearance is an Independent Risk Factor for 30-Day Rebleeding in Patients with Gastric Ulcer Bleeding: A Multicenter Retrospective Study

“…A recent, international, multi-center study has shown that GBS helps predict rebleeding. 29 However, Wang et al 30 and et al 31 compared multiple score systems and found that GBS did not have good performance in predicting rebleeding and 30-day mortality. After multivariate analysis, our results show that a high GBS is a significant factor related to ulcer rebleeding, which may be helpful for the prediction of ulcer rebleeding.…”

Nomogram for predicting rebleeding after initial endoscopic epinephrine injection monotherapy hemostasis in patients with peptic ulcer bleeding: a retrospective cohort study

“…Unlike other clinical trials and guidelines [20][21], our present study showed no signi cant differences in rebleeding in the use of NSAID (3.9% vs. 2.9%; p = 0.698) or antiplatelet (3.9% vs. 4.5%; p = 0.845) drugs; we think this may be due to the small sample size of the chosen groups. The use of the Blatchford score and Rockall score in the prediction of rebleeding in PUB patients after endoscopy EI remains controversial in different studies [22][23]. Budimir et al [22] reported that the Blatchford score better predicted overall rebleeding risk than the Rockall score.…”

“…Budimir et al [22] reported that the Blatchford score better predicted overall rebleeding risk than the Rockall score. However, Liu S et al [23] concluded that the Rockall and Blatchford scores are equivalent in predicting the rebleeding of acute upper gastrointestinal bleeding. In our study, the Rockall score was an independent predictor of rebleeding, but the Blatchford score still had a high e cacy (p < 0.001) in predicting rebleeding.…”