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Year 2025, Volume: 52 Issue: 2, 207 - 217, 20.06.2025

Remzi Çetinkaya , Mehmet Üstündağ , Murat Orak , Recep Dursun , Cahfer Güloğlu

https://doi.org/10.5798/dicletip.1722816

Abstract

References

  • 1.Bodh V, Sharma B, Kumar R, Sharma R. Currenttrends in etiological profile of acute uppergastrointestinal bleeding in Northern India: aretrospective analysis of 5-year endoscopic data. JDig Endosc. 2021;12(1):031-5.
  • 2.Nable JV, Graham AC. Gastrointestinal bleeding.Emerg Med Clin North Am. 2016;34(2):309-25.
  • 3.Li Y, Song Y. Diagnostic value of serum gastrin andepidermal growth factor to the gastric ulcercomplicated with upper gastrointestinalhemorrhage. J Coll Physicians Surg Pak.2020;30(12):1269-73.
  • 4.Tatlıparmak AC, Dikme Ö, Dikme Ö, Topaçoğlu H.Cancer, platelet distribution width, and total proteinlevels as predictors of rebleeding in uppergastrointestinal bleeding. PeerJ. 2022;10:e14061.
  • 5.Ebrahimi Bakhtavar H, Morteza Bagi HR, RahmaniF, Shahsavari Nia K, Ettehadi A. Clinical scoringsystems in predicting the outcome of acute uppergastrointestinal bleeding; a narrative review. Emerg(Tehran). 2017;5(1):e36.
  • 6.Saltzman JR, Tabak YP, Hyett BH, Sun X, Travis AC,Johannes RS. A simple risk score accurately predictsin-hospital mortality, length of stay, and cost inacute upper GI bleeding. Gastrointest Endosc. 2011;74(6):1215-24.
  • 7.Stanley AJ, Laine L, Dalton HR, et al. Comparison of risk scoring systems for patients presenting withupper gastrointestinal bleeding: internationalmulticentre prospective study. BMJ. 2017;356:j442.
  • 8.Uçmak F, Tuncel ET. Varis dışı üst gastrointestinalsistem kanamalı hastalarda klinik seyri öngörmedeendoskopi öncesi risk skorlarının etkinliği. DicleMed J. 2024;50(1):98-105.
  • 9.Mokhtare M, Bozorgi V, Agah S, et al. Comparisonof Glasgow-Blatchford score and full Rockall scoresystems to predict clinical outcomes in patients with upper gastrointestinal bleeding. Clin ExpGastroenterol. 2016;9:337-43.
  • 10.Morarasu BC, Sorodoc V, Haisan A, et al. Age,blood tests and comorbidities and AIMS65 riskscores outperform Glasgow-Blatchford and pre-endoscopic Rockall score in patients with uppergastrointestinal bleeding. World J Clin Cases.2023;11(19):4513-23.
  • 11.Rockall TA, Logan RF, Devlin HB, Northfield T.Risk assessment after acute upper gastrointestinalhaemorrhage. Gut. 1996;38(3):316-21.
  • 12.Ozel M, Gaffari E, Topacoglu H, Karcıoğlu Ö. Useof National Early Warning Score and perfusion index in predicting outcomes of elderly emergencydepartment patients. Gen Med J. 2023;33(1):36-40.
  • 13.Gralnek I. M., Barkun A. N., & Bardou M. (2008).Management of acute bleeding from a peptic ulcer.New England Journal of Medicine, 359(9), 928-37.
  • 14.Ak R, Hökenek NM. Comparison of AIMS65 andGlasgow Blatchford scores in predicting mortality inpatients with upper gastrointestinal bleeding. RevAssoc Med Bras (1992). 2021;67(5):766-70.
  • 15.Wang CY, Qin J, Wang J, et al. Rockall score inpredicting outcomes of elderly patients with acuteupper gastrointestinal bleeding. World JGastroenterol. 2013;19(22):3466-72.
  • 16.Bozkurt S, Köse A, Arslan ED, et al. Validity ofmodified early warning, Glasgow Blatchford, andpre-endoscopic Rockall scores in predictingprognosis of patients presenting to emergencydepartment with upper gastrointestinal bleeding.Scand J Trauma Resusc Emerg Med. 2015;23:1-9.
  • 17.Aydin H, Berikol GB, Erdogan MO, Gemici E,Doğan H. CHAMPS score in predicting mortality ofpatients with acute nonvariceal uppergastrointestinal bleeding. Rev Assoc Med Bras(1992). 2023;69(4):e20221052.
  • 18. Çomoğlu M, Acehan F. Üst gastrointestinal sistemkanaması ile başvuran hastalarda başvuru laktatdüzeyi ve nötrofil-lenfosit oranının mortalite ileilişkisi. Akad Gastroenterol Derg. 2023;22(2):119-26.
  • 19.Raj A, Kaeley N, Prasad H, et al. Prospectiveobservational study on clinical and epidemiologicalprofile of adult patients presenting to the emergency department with suspected upper gastrointestinalbleed. BMC Emerg Med. 2023;23(1):107.
  • 20.Altıntaş E, Ateş S, Ongar M, et al. Risk markers formortality in hemodynamically stable patientsadmitted to the emergency department with aprediagnosis of upper gastrointestinal bleeding.Sağlık Bilimlerinde Değer. 2023;13(3):378-84.
  • 21.Liu S, Zhang X, Walline JH, Yu X, Zhu H.Comparing the performance of the ABC, AIMS65,GBS, and pRS scores in predicting 90-day mortalityor rebleeding among emergency departmentpatients with acute upper gastrointestinal bleeding:a prospective multicenter study. J Transl Intern Med. 2021;9(2):114-22.
  • 22.Kılıç M, Ak R, Alışkan H. Use of the AIMS65 andpre-endoscopy Rockall scores in the prediction ofmortality in patients with upper gastrointestinalbleeding. Ulus Travma Acil Cerrahi Derg.2022;29(1):100-4.
  • 23.Hyett BH, Abougergi MS, Charpentier JP, et al.The AIMS65 score compared with the Glasgow-Blatchford score in predicting outcomes in upper GIbleeding. Gastrointest Endosc. 2013;77(4):551-7.
  • 24.Kim MS, Choi J, Shin WC. AIMS65 scoring systemis comparable to Glasgow-Blatchford score orRockall score for prediction of clinical outcomes fornon-variceal upper gastrointestinal bleeding. BMCGastroenterol. 2019;19:1-8.
  • 25.Robertson M, Majumdar A, Boyapati R, et al. Riskstratification in acute upper GI bleeding:comparison of the AIMS65 score with the Glasgow-Blatchford and Rockall scoring systems.Gastrointest Endosc. 2016;83(6):1151-60.
  • 26.Abougergi MS, Charpentier JP, Bethea E, et al. Aprospective, multicenter study of the AIMS65 scorecompared with the Glasgow-Blatchford score inpredicting upper gastrointestinal hemorrhageoutcomes. J Clin Gastroenterol. 2016;50(6):464-9.
  • 27.Benedeto-Stojanov D, Bjelaković M, Stojanov D,Aleksovski B. Prediction of in-hospital mortalityafter acute upper gastrointestinal bleeding: cross-validation of several risk scoring systems. J Int MedRes. 2022;50(3):03000605221086442.
  • 28.Dertli R, Toka B, Asıl M, et al. Can neutrophil-lymphocyte ratio predict mortality in acute non-variceal upper gastrointestinal bleeding? Turk JTrauma Emerg Surg. 2022;28(5):626.
  • 29.Payza U. Hemogram parametrelerinin,inflamatuar barsak hastalığı olan hastalarda hastalıkşiddeti, mortalite ve komplikasyonları öngörmedekirolü. Dokuz Eylül Üniv Tıp Fak Derg.2021;35(2):147-57.
  • 30. Tian XC, Liu XL, Zeng FR, Chen Z, Wu DH. Platelet-to-lymphocyte ratio acts as an independent riskfactor for patients with hepatitis B virus-relatedhepatocellular carcinoma who receivedtransarterial chemoembolization. Eur Rev MedPharmacol Sci. 2016;20(11).

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

Year 2025, Volume: 52 Issue: 2, 207 - 217, 20.06.2025

Remzi Çetinkaya , Mehmet Üstündağ , Murat Orak , Recep Dursun , Cahfer Güloğlu

https://doi.org/10.5798/dicletip.1722816

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

References

  • 1.Bodh V, Sharma B, Kumar R, Sharma R. Currenttrends in etiological profile of acute uppergastrointestinal bleeding in Northern India: aretrospective analysis of 5-year endoscopic data. JDig Endosc. 2021;12(1):031-5.
  • 2.Nable JV, Graham AC. Gastrointestinal bleeding.Emerg Med Clin North Am. 2016;34(2):309-25.
  • 3.Li Y, Song Y. Diagnostic value of serum gastrin andepidermal growth factor to the gastric ulcercomplicated with upper gastrointestinalhemorrhage. J Coll Physicians Surg Pak.2020;30(12):1269-73.
  • 4.Tatlıparmak AC, Dikme Ö, Dikme Ö, Topaçoğlu H.Cancer, platelet distribution width, and total proteinlevels as predictors of rebleeding in uppergastrointestinal bleeding. PeerJ. 2022;10:e14061.
  • 5.Ebrahimi Bakhtavar H, Morteza Bagi HR, RahmaniF, Shahsavari Nia K, Ettehadi A. Clinical scoringsystems in predicting the outcome of acute uppergastrointestinal bleeding; a narrative review. Emerg(Tehran). 2017;5(1):e36.
  • 6.Saltzman JR, Tabak YP, Hyett BH, Sun X, Travis AC,Johannes RS. A simple risk score accurately predictsin-hospital mortality, length of stay, and cost inacute upper GI bleeding. Gastrointest Endosc. 2011;74(6):1215-24.
  • 7.Stanley AJ, Laine L, Dalton HR, et al. Comparison of risk scoring systems for patients presenting withupper gastrointestinal bleeding: internationalmulticentre prospective study. BMJ. 2017;356:j442.
  • 8.Uçmak F, Tuncel ET. Varis dışı üst gastrointestinalsistem kanamalı hastalarda klinik seyri öngörmedeendoskopi öncesi risk skorlarının etkinliği. DicleMed J. 2024;50(1):98-105.
  • 9.Mokhtare M, Bozorgi V, Agah S, et al. Comparisonof Glasgow-Blatchford score and full Rockall scoresystems to predict clinical outcomes in patients with upper gastrointestinal bleeding. Clin ExpGastroenterol. 2016;9:337-43.
  • 10.Morarasu BC, Sorodoc V, Haisan A, et al. Age,blood tests and comorbidities and AIMS65 riskscores outperform Glasgow-Blatchford and pre-endoscopic Rockall score in patients with uppergastrointestinal bleeding. World J Clin Cases.2023;11(19):4513-23.
  • 11.Rockall TA, Logan RF, Devlin HB, Northfield T.Risk assessment after acute upper gastrointestinalhaemorrhage. Gut. 1996;38(3):316-21.
  • 12.Ozel M, Gaffari E, Topacoglu H, Karcıoğlu Ö. Useof National Early Warning Score and perfusion index in predicting outcomes of elderly emergencydepartment patients. Gen Med J. 2023;33(1):36-40.
  • 13.Gralnek I. M., Barkun A. N., & Bardou M. (2008).Management of acute bleeding from a peptic ulcer.New England Journal of Medicine, 359(9), 928-37.
  • 14.Ak R, Hökenek NM. Comparison of AIMS65 andGlasgow Blatchford scores in predicting mortality inpatients with upper gastrointestinal bleeding. RevAssoc Med Bras (1992). 2021;67(5):766-70.
  • 15.Wang CY, Qin J, Wang J, et al. Rockall score inpredicting outcomes of elderly patients with acuteupper gastrointestinal bleeding. World JGastroenterol. 2013;19(22):3466-72.
  • 16.Bozkurt S, Köse A, Arslan ED, et al. Validity ofmodified early warning, Glasgow Blatchford, andpre-endoscopic Rockall scores in predictingprognosis of patients presenting to emergencydepartment with upper gastrointestinal bleeding.Scand J Trauma Resusc Emerg Med. 2015;23:1-9.
  • 17.Aydin H, Berikol GB, Erdogan MO, Gemici E,Doğan H. CHAMPS score in predicting mortality ofpatients with acute nonvariceal uppergastrointestinal bleeding. Rev Assoc Med Bras(1992). 2023;69(4):e20221052.
  • 18. Çomoğlu M, Acehan F. Üst gastrointestinal sistemkanaması ile başvuran hastalarda başvuru laktatdüzeyi ve nötrofil-lenfosit oranının mortalite ileilişkisi. Akad Gastroenterol Derg. 2023;22(2):119-26.
  • 19.Raj A, Kaeley N, Prasad H, et al. Prospectiveobservational study on clinical and epidemiologicalprofile of adult patients presenting to the emergency department with suspected upper gastrointestinalbleed. BMC Emerg Med. 2023;23(1):107.
  • 20.Altıntaş E, Ateş S, Ongar M, et al. Risk markers formortality in hemodynamically stable patientsadmitted to the emergency department with aprediagnosis of upper gastrointestinal bleeding.Sağlık Bilimlerinde Değer. 2023;13(3):378-84.
  • 21.Liu S, Zhang X, Walline JH, Yu X, Zhu H.Comparing the performance of the ABC, AIMS65,GBS, and pRS scores in predicting 90-day mortalityor rebleeding among emergency departmentpatients with acute upper gastrointestinal bleeding:a prospective multicenter study. J Transl Intern Med. 2021;9(2):114-22.
  • 22.Kılıç M, Ak R, Alışkan H. Use of the AIMS65 andpre-endoscopy Rockall scores in the prediction ofmortality in patients with upper gastrointestinalbleeding. Ulus Travma Acil Cerrahi Derg.2022;29(1):100-4.
  • 23.Hyett BH, Abougergi MS, Charpentier JP, et al.The AIMS65 score compared with the Glasgow-Blatchford score in predicting outcomes in upper GIbleeding. Gastrointest Endosc. 2013;77(4):551-7.
  • 24.Kim MS, Choi J, Shin WC. AIMS65 scoring systemis comparable to Glasgow-Blatchford score orRockall score for prediction of clinical outcomes fornon-variceal upper gastrointestinal bleeding. BMCGastroenterol. 2019;19:1-8.
  • 25.Robertson M, Majumdar A, Boyapati R, et al. Riskstratification in acute upper GI bleeding:comparison of the AIMS65 score with the Glasgow-Blatchford and Rockall scoring systems.Gastrointest Endosc. 2016;83(6):1151-60.
  • 26.Abougergi MS, Charpentier JP, Bethea E, et al. Aprospective, multicenter study of the AIMS65 scorecompared with the Glasgow-Blatchford score inpredicting upper gastrointestinal hemorrhageoutcomes. J Clin Gastroenterol. 2016;50(6):464-9.
  • 27.Benedeto-Stojanov D, Bjelaković M, Stojanov D,Aleksovski B. Prediction of in-hospital mortalityafter acute upper gastrointestinal bleeding: cross-validation of several risk scoring systems. J Int MedRes. 2022;50(3):03000605221086442.
  • 28.Dertli R, Toka B, Asıl M, et al. Can neutrophil-lymphocyte ratio predict mortality in acute non-variceal upper gastrointestinal bleeding? Turk JTrauma Emerg Surg. 2022;28(5):626.
  • 29.Payza U. Hemogram parametrelerinin,inflamatuar barsak hastalığı olan hastalarda hastalıkşiddeti, mortalite ve komplikasyonları öngörmedekirolü. Dokuz Eylül Üniv Tıp Fak Derg.2021;35(2):147-57.
  • 30. Tian XC, Liu XL, Zeng FR, Chen Z, Wu DH. Platelet-to-lymphocyte ratio acts as an independent riskfactor for patients with hepatitis B virus-relatedhepatocellular carcinoma who receivedtransarterial chemoembolization. Eur Rev MedPharmacol Sci. 2016;20(11).
There are 30 citations in total.

Details

Primary Language English
Subjects Medical Education, Health Services and Systems (Other)
Journal Section Original Articles
Authors

Remzi Çetinkaya

Mehmet Üstündağ

Murat Orak

Recep Dursun

Cahfer Güloğlu

Publication Date June 20, 2025
Submission Date December 11, 2024
Acceptance Date April 16, 2025
Published in Issue Year 2025 Volume: 52 Issue: 2

Cite

APA Çetinkaya, R., Üstündağ, M., Orak, M., Dursun, R., et al. (2025). Upper Gastrointestinal Bleeding: A Comparative Analysis of Aims65, News+L, Rockall, and Gbs in Predicting in-Hospital Mortality. Dicle Medical Journal, 52(2), 207-217. https://doi.org/10.5798/dicletip.1722816
AMA Çetinkaya R, Üstündağ M, Orak M, Dursun R, Güloğlu C. Upper Gastrointestinal Bleeding: A Comparative Analysis of Aims65, News+L, Rockall, and Gbs in Predicting in-Hospital Mortality. diclemedj. June 2025;52(2):207-217. doi:10.5798/dicletip.1722816
Chicago Çetinkaya, Remzi, Mehmet Üstündağ, Murat Orak, Recep Dursun, and Cahfer Güloğlu. “Upper Gastrointestinal Bleeding: A Comparative Analysis of Aims65, News+L, Rockall, and Gbs in Predicting in-Hospital Mortality”. Dicle Medical Journal 52, no. 2 (June 2025): 207-17. https://doi.org/10.5798/dicletip.1722816.
EndNote Çetinkaya R, Üstündağ M, Orak M, Dursun R, Güloğlu C (June 1, 2025) Upper Gastrointestinal Bleeding: A Comparative Analysis of Aims65, News+L, Rockall, and Gbs in Predicting in-Hospital Mortality. Dicle Medical Journal 52 2 207–217.
IEEE R. Çetinkaya, M. Üstündağ, M. Orak, R. Dursun, and C. Güloğlu, “Upper Gastrointestinal Bleeding: A Comparative Analysis of Aims65, News+L, Rockall, and Gbs in Predicting in-Hospital Mortality”, diclemedj, vol. 52, no. 2, pp. 207–217, 2025, doi: 10.5798/dicletip.1722816.
ISNAD Çetinkaya, Remzi et al. “Upper Gastrointestinal Bleeding: A Comparative Analysis of Aims65, News+L, Rockall, and Gbs in Predicting in-Hospital Mortality”. Dicle Medical Journal 52/2 (June 2025), 207-217. https://doi.org/10.5798/dicletip.1722816.
JAMA Çetinkaya R, Üstündağ M, Orak M, Dursun R, Güloğlu C. Upper Gastrointestinal Bleeding: A Comparative Analysis of Aims65, News+L, Rockall, and Gbs in Predicting in-Hospital Mortality. diclemedj. 2025;52:207–217.
MLA Çetinkaya, Remzi et al. “Upper Gastrointestinal Bleeding: A Comparative Analysis of Aims65, News+L, Rockall, and Gbs in Predicting in-Hospital Mortality”. Dicle Medical Journal, vol. 52, no. 2, 2025, pp. 207-1, doi:10.5798/dicletip.1722816.
Vancouver Çetinkaya R, Üstündağ M, Orak M, Dursun R, Güloğlu C. Upper Gastrointestinal Bleeding: A Comparative Analysis of Aims65, News+L, Rockall, and Gbs in Predicting in-Hospital Mortality. diclemedj. 2025;52(2):207-1.
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