Predicting Mortality in Non-Variceal Upper Gastrointestinal Bleeding: A Comparative Analysis of Five Risk Scores

Objective: This study aimed to compare the predictive accuracy of five commonly used clinical scoring systems - albumin, international normalised ratio,altered mental status, systolic blood pressure, age (AIMS65), Charlson Comorbidity Index ≥2, in-hospital onset, albumin <2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥2, and steroid use (CHAMPS), age, blood tests, and comorbidities (ABC), Glasgow-Blatchford score (GBS), and Complete Rockall score (CRS)- in estimating in-hospital mortality among patients presenting with non-variceal upper gastrointestinal bleeding (UGIB). Materials and Methods: This retrospective, single-center observational study included 917 adult patients diagnosed with non-variceal UGIB between January 2020 and January 2025. Clinical data were extracted from electronic medical records. Each patient’s risk scores (AIMS65, CHAMPS, ABC, GBS, and CRS) were calculated based on admission data. The predictive performance of each scoring system for in-hospital mortality was assessed using receiver operating characteristic curve analysis, and area under the curve (AUC) values were compared using the DeLong test. Results: The overall in-hospital mortality rate was 5.2%. AIMS65 demonstrated the highest predictive performance (AUC: 0.815, 95% confidence interval: 0.788-0.840), significantly outperforming GBS (AUC: 0.631, p<0.001) and showing comparable accuracy to CHAMPS (AUC: 0.801, p=0.493). The CHAMPS score also showed good discriminatory power, particularly in high-risk patients. The ABC score (AUC: 0.708) and CRS (AUC: 0.702) demonstrated moderate predictive ability, while GBS had the lowest accuracy. Conclusion: Among the five evaluated scoring systems, AIMS65 exhibited the best performance in predicting in-hospital mortality in non-variceal UGIB patients, followed closely by CHAMPS.