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The following is a summary of “Efficacy and comparison of upper gastrointestinal bleeding risk scoring systems on predicting clinical outcomes among emergency unit patients,” published in the February 2025 issue of the BMC Gastroenterology by Arıkoğlu et al.

Gastrointestinal bleeding is a critical medical emergency associated with significant morbidity and mortality. Early risk stratification is essential for optimizing patient management and improving clinical outcomes. Several validated scoring systems, including the Glasgow Blatchford Bleeding Score (GBS), AIMS65 score, Rockall Score (RS), and International Bleeding Risk Score (INBS; also known as the ABC score), have been developed to predict key outcomes such as hospitalization, the need for blood transfusion, endoscopic intervention, and mortality. This study aimed to assess the predictive performance and clinical utility of these scoring systems in emergency unit patients presenting with GI bleeding.

A retrospective analysis was conducted on adult patients admitted to the emergency unit with GI bleeding. Patient demographics, presenting symptoms, vital signs, physical examination findings, laboratory results, clinical outcomes, blood transfusion requirements, and endoscopic interventions were recorded. The GBS, AIMS65, RS, and INBS (ABC) scores were calculated for each patient, and their predictive accuracy for hospitalization, transfusion needs, risk stratification, and mortality was evaluated using statistical analyses, including receiver operating characteristic curve and area under the curve assessments.

A total of 311 patients were included in the study, with a median age of 70 years (interquartile range: 59–81), and 65% of them were male (n=202). The analysis demonstrated that all four scoring systems—GBS, AIMS65, RS, and INBS (ABC)—were statistically significant predictors of hospitalization, blood transfusion requirements, risk stratification, and mortality (p < 0.05 for all). However, ROC-AUC analysis indicated that GBS had the highest predictive value for hospitalization, while INBS (ABC) was the most reliable predictor of mortality. Furthermore, RS was the only scoring system that successfully predicted the need for endoscopic intervention (p < 0.05), whereas GBS, AIMS65, and INBS (ABC) did not demonstrate significant predictive capability in this regard.

In conclusion, this study highlights the clinical relevance of GBS, AIMS65, RS, and INBS (ABC) scores in predicting hospitalization, blood transfusion needs, and mortality in patients with GI bleeding. Among these, GBS emerged as the most effective tool for determining hospitalization risk, while INBS (ABC) demonstrated superior predictive accuracy for mortality. Importantly, RS was the only scoring model capable of predicting the need for endoscopic intervention. These findings support the integration of these scoring systems into clinical practice to enhance decision-making and optimize resource allocation in the emergency setting. However, further prospective studies are warranted to validate these results and refine risk stratification strategies for GI bleeding management.

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-025-03684-7