Assessment of the Prognostic Value of the ABC Score in Non-Variceal UGIB Showing Superiority to Traditional Scores, With Room for Improvement: A Retrospective Observational Study
- Author:
Selen KIM
1
;
Sangyeong LEE
;
Ilsoo KIM
;
Jong-Uk HOU
;
Byung-Wook KIM
Author Information
- Publication Type:Original Article
- From:The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2025;25(4):355-362
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Objectives:Upper gastrointestinal bleeding (UGIB) is a critical medical emergency with a potentially fatal outcome. Early risk stratification is essential for determining the need for urgent interventions. Current guidelines recommend the use of risk-stratification models, among which the ABC score was recently developed. We aimed to validate the performance of the ABC score in comparison with the well-established Glasgow–Blatchford score (GBS), AIMS65, and pre-endoscopic Rockall score (PreRS).
Methods:This retrospective single-center study included adult patients (≥18 years) who presented to the emergency department of Incheon St. Mary’s Hospital with non-variceal UGIB between March 2019 and June 2022. The primary outcome was 30-day all-cause mortality. Secondary outcomes included a composite endpoint of hemostatic intervention (endoscopic, interventional radiologic, or surgical), hypotension (systolic blood pressure <90 mm Hg after 2 h), vasopressor use after 2 h, and rebleeding within 7 days. The predictive performance of the GBS, AIMS65, PreRS, and ABC scores was assessed using the area under the receiver operating characteristic curve (AUROC).
Results:Of the 1597 enrolled patients, 116 (7.3%) died within 30 days. The ABC score demonstrated the highest performance (AUROC: 0.806; 95% confidence interval: 0.766–0.845) at predicting 30-day mortality, followed by the PreRS (0.734), GBS (0.679), and AIMS65 (0.558). The GBS had the highest AUROC (0.708), followed by the ABC (0.651), PreRS (0.626), and AIMS65 (0.529).
Conclusions:The ABC score outperformed conventional risk models at predicting the 30-day mortality among patients with non-variceal UGIB. However, its predictive power for the need for intervention was inferior to that of the GBS.
