Comparative Performance Analysis of Aims65, Pre-Endoscopic Rockall, Glasgow-Blatchford, and Modified Age Blood Test Comorbidity Scores in Emergency Department Non-Variceal Upper Gastrointestinal Bleeding

<h3>Background</h3><p dir="ltr">Upper gastrointestinal bleeding (UGIB) can lead to significant morbidity and mortality. Assessing the need for endoscopic interventions and predicting in-hospital mortality are critical, particularly where access to endoscopy is limited. &l...

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Main Author: Nurullah İshak Işık (22466086) (author)
Other Authors: Attila Beştemir (22466089) (author), Gülhan Kurtoğlu Çelik (22466092) (author), Ahmed Enes Demirci (22466095) (author), Safa Dönmez (22466098) (author), Yunus Yatmaz (22466101) (author), Yusuf Yavuz (22466104) (author), Halil Dogan (22466107) (author), Yavuz Yigit (17788490) (author)
Published: 2025
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_version_ 1864513534670405632
author Nurullah İshak Işık (22466086)
author2 Attila Beştemir (22466089)
Gülhan Kurtoğlu Çelik (22466092)
Ahmed Enes Demirci (22466095)
Safa Dönmez (22466098)
Yunus Yatmaz (22466101)
Yusuf Yavuz (22466104)
Halil Dogan (22466107)
Yavuz Yigit (17788490)
author2_role author
author
author
author
author
author
author
author
author_facet Nurullah İshak Işık (22466086)
Attila Beştemir (22466089)
Gülhan Kurtoğlu Çelik (22466092)
Ahmed Enes Demirci (22466095)
Safa Dönmez (22466098)
Yunus Yatmaz (22466101)
Yusuf Yavuz (22466104)
Halil Dogan (22466107)
Yavuz Yigit (17788490)
author_role author
dc.creator.none.fl_str_mv Nurullah İshak Işık (22466086)
Attila Beştemir (22466089)
Gülhan Kurtoğlu Çelik (22466092)
Ahmed Enes Demirci (22466095)
Safa Dönmez (22466098)
Yunus Yatmaz (22466101)
Yusuf Yavuz (22466104)
Halil Dogan (22466107)
Yavuz Yigit (17788490)
dc.date.none.fl_str_mv 2025-08-06T06:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.jemermed.2025.03.016
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Comparative_Performance_Analysis_of_Aims65_Pre-Endoscopic_Rockall_Glasgow-Blatchford_and_Modified_Age_Blood_Test_Comorbidity_Scores_in_Emergency_Department_Non-Variceal_Upper_Gastrointestinal_Bleeding/30405214
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
endoscopy
gastrointestinal hemorrhage
upper gastrointestinal tractearly medical intervention
mortality
dc.title.none.fl_str_mv Comparative Performance Analysis of Aims65, Pre-Endoscopic Rockall, Glasgow-Blatchford, and Modified Age Blood Test Comorbidity Scores in Emergency Department Non-Variceal Upper Gastrointestinal Bleeding
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">Upper gastrointestinal bleeding (UGIB) can lead to significant morbidity and mortality. Assessing the need for endoscopic interventions and predicting in-hospital mortality are critical, particularly where access to endoscopy is limited. </p><h3>Objective</h3><p dir="ltr">This study evaluates the predictive accuracy of pre-endoscopy risk-scoring systems for identifying the need for endoscopic interventions and assessing in-hospital mortality in UGIB patients. </p><h3>Methods</h3><p dir="ltr">We conducted a retrospective cohort study in a tertiary emergency department with 450,000 annual visits. Patients aged ≥18 years presenting with UGIB and undergoing endoscopy between June 1, 2021, and July 31, 2022, were included. Glasgow-Blatchford, pre-endoscopic Rockall, AIMS65, and modified age blood test comorbidity (ABC) scores were calculated using clinical and laboratory data. </p><h3>Results </h3><p dir="ltr">Of 795 patients, 142 required endoscopic interventions and 653 did not. The Glasgow-Blatchford score predicted intervention needs (<i>p</i> = 0.007) but lacked clinical relevance. All scores predicted mortality (p < 0.001); however, AIMS65 and the modified ABC score had the highest predictive accuracy, especially in those requiring interventions (<i>p</i> < 0.001). </p><h3>Conclusion</h3><p dir="ltr">Pre-endoscopy scores have limited utility in predicting intervention needs. Male gender, hematemesis, melena, elevated urea, and low red cell distribution width (RDW) may indicate intervention requirements. The modified ABC score demonstrated strong predictive value for mortality, making it a clinically relevant tool for UGIB risk stratification.</p><h2>Other Information</h2><p dir="ltr">Published in: The Journal of Emergency Medicine<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.jemermed.2025.03.016" target="_blank">https://dx.doi.org/10.1016/j.jemermed.2025.03.016</a></p>
eu_rights_str_mv openAccess
id Manara2_85634e326899999eecb8c0fe5ceb4a8e
identifier_str_mv 10.1016/j.jemermed.2025.03.016
network_acronym_str Manara2
network_name_str Manara2
oai_identifier_str oai:figshare.com:article/30405214
publishDate 2025
repository.mail.fl_str_mv
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rights_invalid_str_mv CC BY 4.0
spelling Comparative Performance Analysis of Aims65, Pre-Endoscopic Rockall, Glasgow-Blatchford, and Modified Age Blood Test Comorbidity Scores in Emergency Department Non-Variceal Upper Gastrointestinal BleedingNurullah İshak Işık (22466086)Attila Beştemir (22466089)Gülhan Kurtoğlu Çelik (22466092)Ahmed Enes Demirci (22466095)Safa Dönmez (22466098)Yunus Yatmaz (22466101)Yusuf Yavuz (22466104)Halil Dogan (22466107)Yavuz Yigit (17788490)Biomedical and clinical sciencesClinical sciencesendoscopygastrointestinal hemorrhageupper gastrointestinal tractearly medical interventionmortality<h3>Background</h3><p dir="ltr">Upper gastrointestinal bleeding (UGIB) can lead to significant morbidity and mortality. Assessing the need for endoscopic interventions and predicting in-hospital mortality are critical, particularly where access to endoscopy is limited. </p><h3>Objective</h3><p dir="ltr">This study evaluates the predictive accuracy of pre-endoscopy risk-scoring systems for identifying the need for endoscopic interventions and assessing in-hospital mortality in UGIB patients. </p><h3>Methods</h3><p dir="ltr">We conducted a retrospective cohort study in a tertiary emergency department with 450,000 annual visits. Patients aged ≥18 years presenting with UGIB and undergoing endoscopy between June 1, 2021, and July 31, 2022, were included. Glasgow-Blatchford, pre-endoscopic Rockall, AIMS65, and modified age blood test comorbidity (ABC) scores were calculated using clinical and laboratory data. </p><h3>Results </h3><p dir="ltr">Of 795 patients, 142 required endoscopic interventions and 653 did not. The Glasgow-Blatchford score predicted intervention needs (<i>p</i> = 0.007) but lacked clinical relevance. All scores predicted mortality (p < 0.001); however, AIMS65 and the modified ABC score had the highest predictive accuracy, especially in those requiring interventions (<i>p</i> < 0.001). </p><h3>Conclusion</h3><p dir="ltr">Pre-endoscopy scores have limited utility in predicting intervention needs. Male gender, hematemesis, melena, elevated urea, and low red cell distribution width (RDW) may indicate intervention requirements. The modified ABC score demonstrated strong predictive value for mortality, making it a clinically relevant tool for UGIB risk stratification.</p><h2>Other Information</h2><p dir="ltr">Published in: The Journal of Emergency Medicine<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.jemermed.2025.03.016" target="_blank">https://dx.doi.org/10.1016/j.jemermed.2025.03.016</a></p>2025-08-06T06:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.jemermed.2025.03.016https://figshare.com/articles/journal_contribution/Comparative_Performance_Analysis_of_Aims65_Pre-Endoscopic_Rockall_Glasgow-Blatchford_and_Modified_Age_Blood_Test_Comorbidity_Scores_in_Emergency_Department_Non-Variceal_Upper_Gastrointestinal_Bleeding/30405214CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/304052142025-08-06T06:00:00Z
spellingShingle Comparative Performance Analysis of Aims65, Pre-Endoscopic Rockall, Glasgow-Blatchford, and Modified Age Blood Test Comorbidity Scores in Emergency Department Non-Variceal Upper Gastrointestinal Bleeding
Nurullah İshak Işık (22466086)
Biomedical and clinical sciences
Clinical sciences
endoscopy
gastrointestinal hemorrhage
upper gastrointestinal tractearly medical intervention
mortality
status_str publishedVersion
title Comparative Performance Analysis of Aims65, Pre-Endoscopic Rockall, Glasgow-Blatchford, and Modified Age Blood Test Comorbidity Scores in Emergency Department Non-Variceal Upper Gastrointestinal Bleeding
title_full Comparative Performance Analysis of Aims65, Pre-Endoscopic Rockall, Glasgow-Blatchford, and Modified Age Blood Test Comorbidity Scores in Emergency Department Non-Variceal Upper Gastrointestinal Bleeding
title_fullStr Comparative Performance Analysis of Aims65, Pre-Endoscopic Rockall, Glasgow-Blatchford, and Modified Age Blood Test Comorbidity Scores in Emergency Department Non-Variceal Upper Gastrointestinal Bleeding
title_full_unstemmed Comparative Performance Analysis of Aims65, Pre-Endoscopic Rockall, Glasgow-Blatchford, and Modified Age Blood Test Comorbidity Scores in Emergency Department Non-Variceal Upper Gastrointestinal Bleeding
title_short Comparative Performance Analysis of Aims65, Pre-Endoscopic Rockall, Glasgow-Blatchford, and Modified Age Blood Test Comorbidity Scores in Emergency Department Non-Variceal Upper Gastrointestinal Bleeding
title_sort Comparative Performance Analysis of Aims65, Pre-Endoscopic Rockall, Glasgow-Blatchford, and Modified Age Blood Test Comorbidity Scores in Emergency Department Non-Variceal Upper Gastrointestinal Bleeding
topic Biomedical and clinical sciences
Clinical sciences
endoscopy
gastrointestinal hemorrhage
upper gastrointestinal tractearly medical intervention
mortality