Comparison of Glasgow Blatchford Score and ABC Score to Predict Outcomes in Patients with Acute Upper GI Bleeding

GBS vs ABC Score in Acute Upper GI Bleeding

Abstract

Background: Acute upper gastrointestinal bleeding is a common medical emergency with high mortality. Risk stratification methods such as the Glasgow Blatchford Score (GBS) and the ABC score predict clinical outcomes and guide early care, although their mortality prediction accuracy varies across groups. Objective: To compare the predictive accuracy of Glasgow Blatchford Score (GBS) and ABC score for mortality in patients presenting with acute upper gastrointestinal bleeding. Study Design: Retrospective cross-sectional analytical study. Settings: Gastroenterology Department, Aziz Fatimah Hospital, Faisalabad Pakistan. Duration: 12 months from February 01, 2025 to January 31, 2026. Methods: Non-probability consecutive sample of 90 individuals were selected after meeting inclusion and exclusion criteria. Clinical, lab, and endoscopic data were documented. GBS and ABC scores were determined. In-hospital mortality was measured. Data was processed with SPSS 27. Predictive performance was assessed using ROC curves. Results: Patients' mean age was 37.49 ± 12.02 years, with 64.4% males. The 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.