Remzi Çetinkaya, S University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Department of Emergency Medicine, Diyarbakır, Türkiye e-mail: cetinkayaremzi2121@gmail.com

Upper Gastrointestinal Bleeding: A Comparative Analysis of Aims65, News+L, Rockall, and Gbs in Predicting in-Hospital Mortality

Abstract

Background: Acute upper gastrointestinal (GI) bleeding is a common and potentially life-threatening emergency frequently seen in emergency departments. Early and accurate risk stratification is essential for guiding clinical management. This study aimed to assess the effectiveness of various clinical scoring systems and laboratory parameters in predicting in-hospital mortality in patients with upper GI bleeding.

Methods: This retrospective study included patients aged 18 and older diagnosed with upper GI bleeding between January 1, 2016, and January 1, 2019. The Glasgow Blatchford Score (GBS), Pre-endoscopic Rockall Score (PRS), total Rockall Score, AIMS65, and NEWS+L scores were calculated. Laboratory parameters were also analyzed for their association with mortality.

Results: A total of 316 patients were included, with an in-hospital mortality rate of 13.3%. Among the scoring systems, AIMS65 and NEWS+L demonstrated higher predictive accuracy (AUC) for in-hospital mortality compared to PRS. GBS and total Rockall scores also performed better than PRS.

Conclusion: AIMS65 and NEWS+L scores were superior to PRS in predicting mortality. Additionally, low hemoglobin, elevated lactate, high neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios, and increased urea-to-creatinine levels were associated with higher mortality risk.

Keywords: Upper gastrointestinal bleeding, Mortality Score, Endoscopy, Prognosis                   

Remzi Çetinkaya, S University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Department of Emergency Medicine, Diyarbakır, Türkiye e-mail: cetinkayaremzi2121@gmail.com

Upper Gastrointestinal Bleeding: A Comparative Analysis of Aims65, News+L, Rockall, and Gbs in Predicting in-Hospital Mortality

Abstract

Background: Acute upper gastrointestinal (GI) bleeding is a common and potentially life-threatening emergency frequently seen in emergency departments. Early and accurate risk stratification is essential for guiding clinical management. This study aimed to assess the effectiveness of various clinical scoring systems and laboratory parameters in predicting in-hospital mortality in patients with upper GI bleeding.

Methods: This retrospective study included patients aged 18 and older diagnosed with upper GI bleeding between January 1, 2016, and January 1, 2019. The Glasgow Blatchford Score (GBS), Pre-endoscopic Rockall Score (PRS), total Rockall Score, AIMS65, and NEWS+L scores were calculated. Laboratory parameters were also analyzed for their association with mortality.

Results: A total of 316 patients were included, with an in-hospital mortality rate of 13.3%. Among the scoring systems, AIMS65 and NEWS+L demonstrated higher predictive accuracy (AUC) for in-hospital mortality compared to PRS. GBS and total Rockall scores also performed better than PRS.

Conclusion: AIMS65 and NEWS+L scores were superior to PRS in predicting mortality. Additionally, low hemoglobin, elevated lactate, high neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios, and increased urea-to-creatinine levels were associated with higher mortality risk.

Keywords: Upper gastrointestinal bleeding, Mortality Score, Endoscopy, Prognosis                   

Üst Gastroıntestınal Kanama: Hastane içi Mortaliteyi Öngörmede Aıms65, News+L, Rockall ve Gbs Skorlarının Karşılaştırmalı Analizi

Öz

Giriş: Akut üst gastrointestinal (GİS) kanama, acil servislerde sık karşılaşılan ve potansiyel olarak hayatı tehdit eden bir acil durumdur. Erken ve doğru risk sınıflaması, klinik yönetimi yönlendirmek açısından hayati öneme sahiptir. Bu çalışmanın amacı, üst GİS kanamalı hastalarda hastane içi mortaliteyi öngörmede çeşitli klinik skorlama sistemleri ile laboratuvar parametrelerinin etkinliğini değerlendirmektir.

Yöntemler: Bu retrospektif çalışmaya, 1 Ocak 2016 ile 1 Ocak 2019 tarihleri arasında üst GİS kanaması tanısıyla acil servise başvuran 18 yaş ve üzeri hastalar dahil edildi. Bu hastalar için Glasgow Blatchford Skoru (GBS), Endoskopi Öncesi Rockall Skoru (PRS), toplam Rockall Skoru, AIMS65 ve NEWS+L skorları hesaplandı. Ayrıca mortalite ile ilişkili laboratuvar parametreleri analiz edildi.

Bulgular: Çalışmaya toplam 316 hasta dahil edildi ve hastane içi mortalite oranı %13,3 olarak belirlendi. Skorlama sistemleri karşılaştırıldığında, AIMS65 ve NEWS+L skorlarının hastane içi mortaliteyi öngörmede PRS’ye göre daha yüksek AUC değerine sahip olduğu görüldü. GBS ve toplam Rockall skorları da PRS’ye kıyasla daha iyi performans gösterdi.

Sonuç: AIMS65 ve NEWS+L skorları, hastane içi mortaliteyi öngörmede PRS’ye göre daha üstündür. Ayrıca, düşük hemoglobin, yüksek laktat, artmış nötrofil/lenfosit (NLR) ve trombosit/lenfosit (PLR) oranları ile artmış üre/kreatinin düzeyleri yüksek mortalite riskiyle ilişkilendirildi.

Anahtar kelimeler: Üst gis kanaması, Mortalite skoru, Endoskopi, Prognoz.                     

Dicle Med J  2025; 52 (2): 207-217

Doi: 10.5798/dicletip.1722816