Comparison of Risk Scoring Systems in Hospitalised Patients who Develop Upper Gastrointestinal Bleeding

Mules, Thomas; Stedman, Catherine A.; Ding, Steven; Burt, Michael; Gearry, Richard; Chalmers-Watson, Teresa; Falvey, James D.; Barclay, Murray L.; Lim, Gary; Chapman, B. A.; Banerjee, Tyara; Ngu, Jeffrey

doi:10.1002/ygh2.436

Cited by 6 publications

(6 citation statements)

References 20 publications

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“…This is particularly important as no previous investigations compared the scores’ ability to predict mortality by type of GI bleeding (variceal vs non-variceal). Our findings also support previous evidence that ABC performs better than GBS or AIMS65 score[ 22 ], also outperforming Progetto Nazionale Emorragia Digestive (PNED) and Rockall score[ 23 ]. Looking at the other three scores, our results show that AIMS65 is superior to GBS and PERS, but with no significant difference in the AUROC value.…”

Section: Discussionsupporting

confidence: 90%

Age, blood tests and comorbidities and AIMS65 risk scores outperform Glasgow-Blatchford and pre-endoscopic Rockall score in patients with upper gastrointestinal bleeding

Morarasu¹,

Șorodoc²,

Haisan³

et al. 2023

World J Clin Cases

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BACKGROUND Upper gastrointestinal (GI) bleeding is a life-threatening condition with high mortality rates. AIM To compare the performance of pre-endoscopic risk scores in predicting the following primary outcomes: In-hospital mortality, intervention (endoscopic or surgical) and length of admission (≥ 7 d). METHODS We performed a retrospective analysis of 363 patients presenting with upper GI bleeding from December 2020 to January 2021. We calculated and compared the area under the receiver operating characteristics curves (AUROCs) of Glasgow-Blatchford score (GBS), pre-endoscopic Rockall score (PERS), albumin, international normalized ratio, altered mental status, systolic blood pressure, age older than 65 (AIMS65) and age, blood tests and comorbidities (ABC), including their optimal cut-off in variceal and non-variceal upper GI bleeding cohorts. We subsequently analyzed through a logistic binary regression model, if addition of lactate increased the score performance. RESULTS All scores had discriminative ability in predicting in-hospital mortality irrespective of study group. AIMS65 score had the best performance in the variceal bleeding group (AUROC = 0.772; P < 0.001), and ABC score (AUROC = 0.775; P < 0.001) in the non-variceal bleeding group. However, ABC score, at a cut-off value of 5.5, was the best predictor (AUROC = 0.770, P = 0.001) of in-hospital mortality in both populations. PERS score was a good predictor for endoscopic treatment (AUC = 0.604; P = 0.046) in the variceal population, while GBS score, (AUROC = 0.722; P = 0.024), outperformed the other scores in predicting surgical intervention. Addition of lactate to AIMS65 score, increases by 5-fold the probability of in-hospital mortality ( P < 0.05) and by 12-fold if added to GBS score ( P < 0.003). No score proved to be a good predictor for length of admission. CONCLUSION ABC score is the most accurate in predicting in-hospital mortality in both mixed and non-variceal bleeding population. PERS and GBS should be used to determine need for endoscopic and surgical intervention, respectively. Lactate can be used as an additional tool to risk scores for predicting in-hospital mortality.

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Section: Discussionsupporting

confidence: 90%

Age, blood tests and comorbidities and AIMS65 risk scores outperform Glasgow-Blatchford and pre-endoscopic Rockall score in patients with upper gastrointestinal bleeding

Morarasu¹,

Șorodoc²,

Haisan³

et al. 2023

World J Clin Cases

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“…In fact, according to Laursen et al the ABC score in UGIB patients (AUROC 0.81) performed better than any of the available UGIB scores for predicting 30-day mortality [ 10 ]. Moreover, in three additional studies by Mules et al, Saffouri et al and Liu et al, the ABC score outperformed all other scores for 30-day mortality in patients with UGIB with an AUROC of 0.85, 0.86 and 0.72 respectively [ 14 – 16 ].…”

Section: Discussionmentioning

confidence: 99%

Validation of the new ABC score for predicting 30-day mortality in gastrointestinal bleeding

et al. 2022

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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.

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“…Additionally, compared to other scoring systems like AIMS65, Rockall, and Glasgow-Blatchford, the ABC score demonstrated similar or significantly better predictive ability in predicting 30-day mortality and early recurrent hemorrhage rates in patients with gastrointestinal bleeding [6][7][8]. Following the study by Laursen S.B., several other studies have also reinforced the solid predictive value of the ABC score in predicting 30-day mortality in patients with upper gastrointestinal bleeding with an accurately predicted AUROC of approximately 0.85 [7,9,10]. However, there is currently a limitation of data available on the value of the ABC score in predicting healthcare facility mortality (typically within about a week) and early re-hemorrhage rates (within five days).…”

Section: Introductionmentioning

confidence: 91%

“…The 30-day mortality rates for high-risk UGIB patients in these three risk groups were 1%, 7%, and 25%, respectively [6]. Additionally, compared to other scoring systems like AIMS65, Rockall, and Glasgow-Blatchford, the ABC score demonstrated similar or significantly better predictive ability in predicting 30-day mortality and early recurrent hemorrhage rates in patients with gastrointestinal bleeding [6][7][8]. Following the study by Laursen S.B., several other studies have also reinforced the solid predictive value of the ABC score in predicting 30-day mortality in patients with upper gastrointestinal bleeding with an accurately predicted AUROC of approximately 0.85 [7,9,10].…”

Section: Introductionmentioning

confidence: 92%

Predictive Significance of the ABC Score for Early Re-Hemorrhage and In-Hospital Mortality in High-Risk Variceal Bleeding among Cirrhotic Patients

Ky,

Trang,

Binh

2023

Diagnostics

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(1) Background: Upper gastrointestinal bleeding due to ruptured varices is a severe complication in patients with cirrhosis, with high rates of recurrent hemorrhage and in-hospital mortality. This study aimed to evaluate the value of the ABC score in predicting two events among 201 cirrhotic patients with high-risk variceal hemorrhage. (2) Methods: The ABC score was calculated and categorized into risk groups of patients, and the association between the ABC score and the rates of early hemorrhagic recurrence and clinic mortality were analyzed. (3) Results: Among 201 patients, 8.0% experienced early rebleeding within five days of admission, and 10.4% died in the hospital. Patients who experienced events had higher average ABC scores compared to those who did not experience these events (p < 0.001), especially in the high-risk group (with ABC score ≥ 8). The ABC score showed an excellent predictive value for in-hospital mortality with an AUROC of 0.804, with the optimal cutoff point being 8 points. Additionally, the ABC score demonstrated an acceptable predictive value for early rebleeding with an AUROC of 0.744, and the best cutoff point was 9 points. (4) Conclusions: The ABC score is closely associated with the rates of early re-hemorrhage and in-hospital mortality in cirrhotic patients with variceal bleeding. This scoring system has the potential for clinical application, aiding in early risk stratification for recurrent bleeding and mortality and allowing for more aggressive interventions in high-risk cases.

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Comparison of Risk Scoring Systems in Hospitalised Patients who Develop Upper Gastrointestinal Bleeding

Cited by 6 publications

References 20 publications

Age, blood tests and comorbidities and AIMS65 risk scores outperform Glasgow-Blatchford and pre-endoscopic Rockall score in patients with upper gastrointestinal bleeding

Age, blood tests and comorbidities and AIMS65 risk scores outperform Glasgow-Blatchford and pre-endoscopic Rockall score in patients with upper gastrointestinal bleeding

Validation of the new ABC score for predicting 30-day mortality in gastrointestinal bleeding

Predictive Significance of the ABC Score for Early Re-Hemorrhage and In-Hospital Mortality in High-Risk Variceal Bleeding among Cirrhotic Patients

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