Novel risk score predicts 1-year mortality in patients with GI bleeding

A new scoring system that incorporates the use of antithrombotic (AT) drugs upon admission can accurately predict mortality in patients with overt gastrointestinal bleeding (GIB) at 1 year, reports a recent study.

A group of researchers developed a risk-scoring system from prospectively collected data on patients admitted with GIB between January 2013 and August 2020 who had at least 1 year of follow-up.

Independent predictors of 1-year mortality were identified after adjusting for confounders, including age-adjusted Charlson Comorbidity Index (CCI; divided into four groups: CCI-0=0, CCI-1=1 to 3, CCI-2=4 to 6, and CCI-3 ≥7), need for blood transfusion, GIB severity, need for endoscopic therapy, and type of AT. The researchers developed the risk score using these predictors.

Of the 576 patients included, 123 (21 percent) died at 1-year follow-up. The novel risk score was based on the following independent predictors: CCI-2 (2 points), CCI-3 (4 points), need for blood transfusion (1 point), and no use of aspirin (1 point) as aspirin use was protective (maximum score=6). Patients who scored high were at greater risk of death.

Notably, the new model demonstrated better predictive accuracy (area under the curve [AUC], 0.82, 95 percent confidence interval [CI], 0.78‒0.86; p<0.0001) compared with the Rockall score for upper GIB (AUC, 0.68; p<0.0001), the Oakland score for lower GIB (AUC, 0.69; p=0.004), or the Shock Index for all (AUC, 0.54; p<0.0001).

“This scoring system may help guide follow-up decisions and inform the prognosis of patients with GIB,” the researchers said.