Comparison and validation of several scoring systems for non-variceal upper gastrointestinal bleeding: a retrospective study

Abstract

Background Non-variceal upper gastrointestinal bleeding (NVUGIB) is a serious medical condition that requires effective risk stratification to guide treatment decisions. Aims This study aimed to compare and validate the predictive performance of several established scoring systems in patients with NVUGIB: Glasgow–Blatchford score (GBS) and the age, blood tests, and comorbidities (ABC), mental status–anesthesiologist score–pulse–albumin–systolic blood pressure–hemoglobin (MAP(ASH)), Japanese, and Charlson comorbidity index-in-hospital onset–albumin-mental status–Eastern Cooperative Oncology Group performance status–steroids (CHAMPS) scores. Methods We retrospectively reviewed the records of 1241 patients with NVUGIB at Chungnam National University Hospital. Each scoring system was evaluated for its ability to predict in-hospital mortality, rebleeding, and the need for radiological or surgical intervention. We also assessed the efficacy of each score in identifying low-risk patients. Results The ABC score showed the highest accuracy in predicting in-hospital mortality (C-statistic, 0.890). The MAP(ASH) score was the most effective predictor of rebleeding and the need for interventions (C-statistic, 0.673 and 0.711, respectively). In low-risk patients, the ABC and Japanese scores were the most effective, with very low associated mortality rates. Conclusions Different scoring systems have been optimized for various clinical outcomes. The ABC score was the best for predicting mortality, whereas the MAP(ASH) score excelled in identifying rebleeding risks and intervention needs. The selection of an appropriate scoring tool based on specific clinical scenarios can improve patient management and resource allocation in NVUGIB.