Comparison of Glasgow Blatchford score and ABC score to predict outcomes in patients with acute upper GI bleeding
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noAbstract
Background: Acute upper gastrointestinal bleeding is a common medical emergency with high mortality. Risk stratification methods like the Glasgow Blatchford Score (GBS) and ABC score predict clinical outcomes and guide early care, although their mortality prediction accuracy varies by group.
Objective: To compare the predictive accuracy of the Glasgow Blatchford Score (GBS) and ABC score for mortality in patients presenting with acute upper gastrointestinal bleeding.
Study Design and Duration of Study: This Retrospective cross sectional analytical study was conducted in the Department of Gastroenterology, Aziz Fatimah Hospital Faisalabad, over a period of 12 months after approval of the study.
Methodology: A non-probability consecutive sample of 90 individuals aged 18–60 with acute upper gastrointestinal hemorrhage was included. The eliminated patients had chronic or lower gastrointestinal hemorrhage and insufficient data. Clinical, lab, and endoscopic data were documented. GBS and ABC scores were determined for each patient. In-hospital mortality was measured. Data were processed with SPSS 27. Predictive performance was assessed using ROC curves.
Results: The mean age of patients was 37.49 ± 12.02 years, with 64.4% males. The overall mortality rate was 15.6%. The mean GBS and ABC scores were 11.97 ± 6.60 and 4.36 ± 2.74, respectively. Both scoring systems showed statistically significant association with mortality (GBS ≥7, p=0.021; ABC ≥4, p=0.001). However, ROC analysis demonstrated poor discriminatory performance, with AUC values of 0.476 for GBS and 0.433 for ABC score.
Conclusion: Acute upper gastrointestinal bleeding mortality was poorly predicted by GBS and ABC score. Clinical value for mortality prediction remains limited, and larger trials are needed to find better prognostic methods.
Key Words: Upper gastrointestinal bleeding, Glasgow Blatchford Score, ABC score, Mortality, Risk stratification.
