Predictors of Mortality in Patient with Upper Gastro-Intestinal Tract Bleeding

Background: Acute upper gastrointestinal bleeding (UGIB) is a medical emergency with a significant mortality risk. Accurate prediction of patient outcomes is vital for optimal triage and management.
Aim: This research aimed to identify predictors of mortality in cases with UGIB and to assess the predictive performance of the AIMS65 and Glasgow-Blatchford (GBS) scoring systems.
Patients and methods: This prospective observational research, 58 cases presenting with UGIB to Mansoura University Emergency Department through the period from May 2023 to May 2024. Demographic data, clinical features, comorbidities, laboratory parameters, and outcomes were analyzed. Patients were assessed using AIMS65 and GBS scores. Primary outcome was mortality; secondary outcomes included re-bleeding, transfusion need, hospital stay, and ICU admission.
Results: The mortality rate was 8.6%. Non-survivors had significantly greater frequency of comorbidities like ischemic heart disease, cancer, and neurological disorders. Laboratory parameters such as elevated serum urea, creatinine, lactate, INR, and low albumin were significantly associated with mortality. Also, non-survivors had higher AIMS65 and GBS scores. An AIMS65 score > 3 predicted mortalities with 94.3% specificity and 80% sensitivity (AUC = 0.925), while a GBS > 13 showed 92.5% specificity and 80% sensitivity (AUC = 0.958).
Conclusion: Mortality in UGIB was influenced by comorbid conditions and specific laboratory abnormalities. AIMS65 and GBS were valuable tools in predicting in-hospital mortality, with AIMS65 demonstrating slightly better performance. Early risk stratification using these scores can guide clinical decision-making and resource allocation in emergency settings.