Comparative Accuracy of Rockall and Glasgow-Blatchford Scores in Predicting Outcomes of Acute Upper Gastrointestinal Bleeding: A Prospective Study at Upper Egypt

Comparative Accuracy of Rockall and Glasgow-Blatchford Scores in Predicting Outcomes of Acute Upper Gastrointestinal Bleeding: A Prospective Study at Upper Egypt | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparative Accuracy of Rockall and Glasgow-Blatchford Scores in Predicting Outcomes of Acute Upper Gastrointestinal Bleeding: A Prospective Study at Upper Egypt Awny Ali Abdelrahman, Aya AwadElkarim Mohamed Osman, Sahar Mohamed Hassany This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9044443/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background: Acute upper gastrointestinal bleeding (UGIB) is a time-sensitive emergency condition associated with significant morbidity and mortality where timely intervention and accurate risk assessment are very important. Aim: To assess and compare the efficiency of the Glasgow-Blatchford Score (GBS) with the Rockall Score (RS) in predicting mortality, morbidity and clinical outcomes among Egyptian patients presenting with acute UGIB. Methods: This prospective observational study’s sample size was 150 overt UGIB patients admitted to Aswan University Hospital. Data collection included clinical, laboratory, and endoscopic data. The assessed outcomes include in-hospital mortality rates, rebleeding events, and the need for intervention. Receiver operating characteristic (ROC) curve analysis and logistic regression were used to assess the predictive performance of both scores( GBS & Rockall). Results: Overall, the first outcome, which was in-hospital mortality, was found to be 5.3%. Mortality cases had significantly higher rates of adverse events including rebleeding, variceal bleeding, and haemodynamic instability. The Glasgow–Blatchford Score demonstrated high sensitivity for predicting the need for intervention (91.4%). ROC analysis identified a GBS cut-off value of >12.5 for mortality prediction (AUC = 0.829), while a Rockall score >4.5 was the optimal threshold for mortality discrimination (AUC = 0.827). Rebleeding was the strongest independent predictor of mortality (OR = 17.4, p = 0.02). Conclusion: Both Glasgow–Blatchford and Rockall scores are reliable tools for risk stratification in Egyptian patients with UGIB. A GBS >12.5 and RS >4.5 are critical thresholds for intensive care and urgent endoscopy. A GBS is superior for identifying patients requiring intervention, whereas the Rockall score better predicts mortality. Routine implementation of both scores may improve early clinical decision-making and patient outcomes. Upper gastrointestinal bleeding Glasgow-Blatchford score Rockall score risk stratification mortality prediction Figures Figure 1 Figure 2 Introduction Acute upper gastrointestinal bleeding (UGIB) accounts for approximately 75% of all cases of acute gastrointestinal bleeding and is one of the major emergencies worldwide. Its incidence is 11 cases per 10,000 population per year ( 1 ). Despite the technological advancements, UGIB is still considered one of the most common medical emergencies that results in substantial morbidity and mortality, with reported mortality rates ranging from 2% to 15% worldwide. In cases of UGIB, time is of the essence. It requires timely assessment and triage of high-risk patients, followed by appropriate management and resource allocation ( 2 ). Risk stratification was invented to aid clinical decision-making at presentation ( 3 – 4 ). Among the most widely used is the Glasgow–Blatchford Score (GBS). It’s main purpose is to determine management strategy, whether the patient needs an endoscopic intervention. Another score is the Rockall Score (RS), in which its purpose is to estimate the risk of rebleeding and mortality based on two main inputs which are the clinical data of the patients and the endoscopic data after the first endoscopy. Both scores are recommended in international guidelines and are routinely used in emergency departments and endoscopy units( 5 – 6 ). Data comparing the predictive performance of GBS and RS in Egyptian patients with UGIB remains limited, particularly in Upper Egypt, where liver disease burden is high. Evaluating these scores in a local population is essential to determine their applicability and to guide evidence-based triage and management strategies. Therefore, the present study aimed to assess the credibility and effectiveness of both scores, GBS and RS, among Egyptian patients presenting with acute UGIB at Aswan University Hospital. Materials and Methods Study Design A prospective observational study design, aiming to assess the predictive accuracy of the Glasgow–Blatchford Score and Rockall Score in acute upper gastrointestinal bleeding patients. Setting and Participants The study was carried out at the Department of Tropical Medicine and Gastroenterology, Aswan University Hospital, Upper Egypt between June 2025 till January 2026 A total of 150 consecutive adult patients (≥ 18 years) presenting with overt upper gastrointestinal bleeding were enrolled. Inclusion and Exclusion Criteria:- *Inclusion criteria : • Adult patients (≥ 18 years) • Presentation with clinical evidence of acute upper gastrointestinal bleeding (hematemesis, melena, hematochezia suspected to be from an upper GI source ) *Exclusion criteria were: • Lower gastrointestinal bleeding • Occult gastrointestinal bleeding • Patients who declined to provide informed consent Data Collection: - All enrolled patients underwent: I - standardized clinical assessment upon admission, including detailed medical history, physical examination, and haemodynamic evaluation. II- Laboratory investigations included Complete blood count( CBC): red blood cells (RBCs), haemoglobin concentration (Hg ), Complete platelet count Blood urea nitrogen, serum Creatinine. III- Upper gastrointestinal endoscopy was performed after initial resuscitation according to standard hospital protocols. Endoscopic findings were classified as variceal or non-variceal bleeding sources. IV- The Glasgow–Blatchford Score was calculated at presentation using clinical and laboratory parameters before endoscopy. The Rockall Score was calculated after endoscopy using clinical and endoscopic variables. - Outcomes : Primary outcomes were in-hospital mortality, rebleeding rates, and the need for clinical interventions (blood transfusion or surgery). - Statistical Analysis : Data were analysed using IBM SPSS v26. Sensitivity, specificity, and area under the ROC curve (AUC) were calculated to evaluate the predictive power and determine the best cut-off points for the Glasgow–Blatchford and Rockall scores. Additionally, we ran a logistic regression analysis to identify independent factors that predict mortality. A p-value < 0.05 was considered to be statistically significant. To compare survivors against non-survivors, we used Chi-square or Fisher’s exact tests for categorical variables and the Mann–Whitney U test for non-parametric continuous variables. Ethical considerations : The study protocol was approved by the Institutional Review Board of Aswan University. The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from all participants before enrolment.( IRB No: Asw/Uni/923/5/24). Results − 150 patients were included in the study. All the patients with acute UGIB according to the inclusion criteria. The median age was found to be 60 years (range: 18–90 years). Regarding the gender distribution, 90 patients (60%) were male. ( Table 1 ) demonstrated that the in-hospital mortality was 5.3% (n = 8 patients) . Clinical and Laboratory Findings :- Non survivors has significantly worse clinical outcomes compared to survivors -Rebleeding occurred in 83.3% of non-survivors compared with 2.8% of survivors (p < 0.001). -Variceal bleeding accounted for 28.6% of the study populations significantly more common among non-survivors than survivors (87.5% vs. 25.4%, p < 0.001). - Additionally, non survivors had significantly lower platelet counts (125.5 vs. 230 ×10⁹/L, p = 0.02). -The need for blood transfusion ( 87.5% vs 38.9%, p = 0.002) and endoscopic intervention( 66.7%vs26.7%, p = 0.02) was significantly higher in non-survivors. Risk scores :- - The precise calculations for the performance of these tests based on the above-defined cut-offs are shown in (Table 2, Fig. 1). Rockall and Glasgow–Blatchford scores were significantly higher among non-survivors. The median Rockall score was 6.5 (IQR: 5.5–7) in non-survivors compared with 4 (IQR: 1–5) in survivors (p = 0.001). Similarly, the median Glasgow–Blatchford score was significantly higher was 15 (IQR 13.5–16) in non-survivors vs. 10 (IQR 6–13) in survivors ,( p = 0.001). The ROC curves showed that a Blatchford score rounded to13 (> 12.5) was associated with a risk of in-hospital mortality with 85.6% sensitivity and 100% specificity (AUC = 0.829). A Rockall score rounded to 5(> 4.5 ) was determined to be the best cut-off point associated with a fatal outcome, with 82.7% sensitivity and 100% specificity (AUC = 0.827). -Prediction of Mortality :- The results of the univariate and multivariate logistic regression are shown in ( Table 3, Fig. 2) with the following variables estimated as the main drivers of fatal outcomes: lower SBP: OR = 1.32 (95% CI: 0.23–7.47), higher heart rate: OR = 1.1 (95% CI: 1.04–1.15), low platelets count OR = 1.1 (95% CI: 0.97–1.3), rebleeding: OR = 13.8 (95% CI: 11.5–41.1), variceal EGD finding: OR = 2.9 (95% CI: 1.7–6.2), RS: OR: 2.09 (95% CI: 1.21–3.58), and GBS: OR = 1.54 (95% CI: 1.09–2.15). Higher Glasgow–Blatchford and Rockall scores were also independently associated with increased mortality risk. Rebleeding remained the strongest independent prediction of morality Table (1): Clinical, lab, and endoscopic features between survivors and non-survivors. Age (years) Survivors N = 142 Non-survivors N = 8 Test of significance p-value Median (IQR) 60 (60– 62) 60(60–62) z=-0.23 p = 0.81 Sex No. % No. % Male 85 59.9 5 62.5 x2 = 0.11 p = 0.73 Female 57 40.1 3 37.5 Comorbidities No. % No. % Present 66 46.5 6 75.0 x2 = 3.12 P = 0.07 Absent 76 53.5 2 25 Clinical manifestation No. % No. % Hematemesis+ melena 50 35.2 7 87.5 x2 = 7.89 p = 0.005* Hematemesis only 57 40.1 1 12.5 x2 = 2.07 p = 0.15 Melena only 35 24.6 0.0 0.0 x2 = 1.38 p = 0.20 Lab measures Creatinine 1.7 (0.8–1.5) 1.8 (0.9–2.5) z = 1.48 p = 0.13 Urea 39 (29– 64) 65 (15– 90) z = 1.46 p = 0.14 Haemoglobin 8.9 ( 6 – 11 ) 6.9 (6.8–71.) z=-1.20 p = 0.02 Platelets 230 (150–293) 126 (80–193) z=-2.27 p = 0.02* EGD finding No. % No. % Variceal EGD 36 25.4 7 87.5 x2 = 17.2 p < 0.001* Complications No. % No. % Rebleeding 4 2.8 6 75.0 x2 = 59 p < 0.001* Transfusion 55 38.9 7 87.5 x2 = 8.8 p = 0.002* Intervention No. % No. % Endoscopic 38 26.7 5 66.7 x2 = 5.3 p = 0.02* Data are presented as frequency (percentage) or median (IQR). x2 : Chi-square test, z: Mann-Whitney u-test, *: significant if (p < 0.05). Table (2): Blatchford and Rockall scores between survivors and non-survivors. Rockall score Survivors N = 142 Non-survivors N = 8 Test of significance p-value Median (IQR) 4 ( 1 – 5 ) 6.5 (5.5–7) z = 3.02 p = 0.001* GBS score Median (IQR) 10 ( 6 – 13 ) 15 (13.5–16) z=-2.94 p = 0.001* Data are presented as median (IQR), z: Mann-Whitney U-test, *: significant if (p < 0.05). Table (3): Logistic regression and ORs for mortality risk assessment after UGIB. Variables referance OR 95% CI p-value OR 95% CI p-value category Lower Upper Lower Upper Age Per 1 year 1.01 0.98 1.06 p = 0.81 - Sex male 0.89 0.82 0.96 p = 0.75 - SBP Per1 mmHg 1.32 0.23 7.47 p = 0.002* 0.87 0.65 1.17 p = 0.38 Heart rate Per 1 bpm 1.10 1.04 1.15 p = 0.002* 0.91 0.78 1.06 p = 0.24 Haematocrit Per 1% 0.92 0.82 1.03 p = 0.15 - Urea Per 1mg/dl 1.0 0.98 1.02 p = 0.68 - Creatinine Per 1mg/dl 1.01 0.68 1.48 p = 0.95 - Platelets Per 10x103 1.1 0.97 1.30 p = 0.03* 1.0 0.99 1.01 p = 0.88 Rebleeding absent 13.8 11.5 41.1 p < 0.001* 17.40 2.38 127.7 P = 0.02* Comorbidities absent 1.00 0.70 1.40 p = 0.10 - Melena absent 3.2 0.36 28.3 p = 0.29 - Variceal EGD Non variceal 2.9 1.70 6.20 p < 0.01* 1.00 0.22 5.20 p = 0.37 GBS Per 1 point 1.54 1.09 2.15 p < 0.001* 1.20 0.57 2.35 p = 0.02* RS Per 1 point 2.09 1.21 3.58 p < 0.007* 3.42 0.22 52.10 p = 0.01* *: significant if (p < 0.05), SBP: systolic blood pressure, GBS: Blatchford Score, RS: Rockall score Figure (1): ROC curve analyses for assessment of the best cut-off points of Blatchford and Rockall scores for discrimination between survivors and non-survivors. Figure (2) : Odds ratios for mortality risk assessment after UGIB. Discussion -The present prospective study evaluated the performance of the Glasgow–Blatchford Score and Rockall Score among Egyptian cases presenting with acute UGIB. The findings demonstrate that both scoring systems are reliable tools for risk stratification; however, each score showed distinct strengths. The Glasgow–Blatchford Score was more sensitive in predicting the need for clinical intervention, while the Rockall Score showed superior performance in predicting in-hospital mortality( 8 ). -The mortality rate was found to be 5.3%, which is comparable to rates reported in international studies which range from 2% to 10%. similar finding were reported by Stanley et al 2000. Non-survivors were characterized by hemodynamic instability, higher rebleeding rates, lower platelet counts, and a markedly higher prevalence of variceal bleeding. These findings highlight the substantial impact of underlying chronic liver disease and portal hypertension on UGIB outcomes in Upper Egypt. -Our results are congruent with previous studies that found that the Glasgow–Blatchford Score is highly sensitive for identifying patients requiring hospital-based intervention (9.10). Large multi-centre studies have shown that GBS performs well in early triage and may safely identify low-risk patients suitable for outpatient management. In contrast, the Rockall Score incorporates both clinical and endoscopic variables, which likely explains its superior ability to predict mortality in the post-endoscopic setting ( 10 ). Rebleeding was the most significant predictor of death (OR = 17.4), highlighting the importance of early endoscopic control. -Although both scores demonstrated good discriminatory ability, their performance may be influenced by regional differences in disease patterns. In Egypt, the high prevalence of chronic liver disease may limit the predictive accuracy of scoring systems originally developed in predominantly non-variceal Western populations. Nevertheless, our findings suggest that both GBS and Rockall scores remain clinically useful in this setting when applied appropriately. ( 11 ) -In our prospective cross-sectional study, both scores showed moderate correlation, reflecting their complementary roles. Comparable results were reported in studies from the UK, Europe, and Asia ( 12 – 14 ). However, some studies suggested that newer scores, such as AIMS65 or ABC, may provide higher mortality prediction accuracy ( 15 ). The strengths of this study are evident in its prospective methodology with standardized data collection, and focus on an Egyptian population that is underrepresented in the current literature. Limitations The limitations of the study are as follow, First, it was conducted at single center, which may limit the generalization of the finding. Second, the sample size was relatively small, particularly the number of mortality events which may affect the robustness of multivariate analysis. Additionally other established scoring systems such as (AIM65, ABC) were not included for comparison, Finally, regional differences in disease patterns, particularly the high prevalence of chronic liver disease in Egypt, may influence the performance of these scoring system Conclusion Our study demonstrated that both the Glasgow- Blatchford and Rockall scores are useful tools for risk stratification in patients with acute UGIB. Both scores show good discriminatory ability in identifying high- risk patients. The Glasgow- Blatchford Score was more sensitive in predicting the need for clinical intervention, whereas the Rockall showed better performance in predicting mortality. However, these findings should be interpreted in light of study limitations. Further large – scale, multi center studies are recommended to validate the results and compare these scores with new risk stratification tools. Recommendations Implementation: Routine use of GBS and RS may be considered in emergency units to aid in risk stratification. Triage: Patients with GBS > 12.5 or RS > 4.5 should be considered for closer monitoring and early interventions . Future Research: Further large-scale studies in Upper Egypt are needed to evaluate newer scoring systems like the ABC or NEWS scores. Declarations Author Contribution A.A.A. and A.A.M. conceptualized and designed the study.A.A.M. and S.M.H. collected the clinical and laboratory data. A.A.M wrote the main manuscript Text A.A.A. performed the upper gastrointestinal endoscopies and documented the findings.A.A.M. performed the statistical analysis and interpreted the data. A.A.A. and A.A.M. drafted the manuscript. S.M.H. critically revised the manuscript for important intellectual content.All authors reviewed and approved the final version of the manuscript. Data Availability The data that support the findings of this study are available from the corresponding author upon reasonable request References Laine L, Barkun AN, Saltzman JR, Martel M, Leontiadis GI (2021) ACG clinical guideline: upper gastrointestinal and ulcer bleeding. Am J Gastroenterol 116(5):899–917 Kulendran K, Pecoraro A, Bashir S (2023) Acute upper gastrointestinal bleeding: an update. InnovAiT 16(11):630–635 Moschovos C, Tsipogiannis K, Konstantakis C, Michopoulos S et al (2023) Comparison of risk scoring systems in predicting clinical outcomes in upper gastrointestinal bleeding: a systematic review and network meta-analysis. J Gastroenterol Hepatol 38(9):1443–1455 Barkun AN, Almadi M, Kuipers EJ, Laine L, Sung J, Tse F et al (2019) Management of nonvariceal upper gastrointestinal bleeding: guideline recommendations from the international consensus group. Ann Intern Med 171(11):805–822 Khan MY, Kamal F (2023) Risk stratification in upper gastrointestinal bleeding: a comprehensive review. World J Gastrointest Pharmacol Ther 14(4):55–68 Speranza R, Fugazza A, Bove V, Repici A, Anderloni A (2024) Risk stratification in acute upper gastrointestinal bleeding: a state-of-the-art review. Dig Liver Dis 56(2):189–197 Blatchford O, Murray WR, Blatchford M (2000) A risk score to predict need for treatment for upper gastrointestinal haemorrhage. Lancet 356:1318–1321 Nazar S, McAvoy C, Stanley AJ (2023) Risk stratification and timing of endoscopy in upper gastrointestinal bleeding: an update. Frontline Gastroenterol 14(3):255–261 Stanley AJ, Laine L, Dalton HR, Ngu JH, Schultz M, Abazi R et al (2011) Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicenter prospective study. BMJ 342:d458 Rockall TA, Logan RF, Devlin HB, Northfield TC (1996) Risk assessment after acute upper gastrointestinal haemorrhage. Gut 38:316–321 Kamal F, Khan MA, Ali B (2023) Utility of pre-endoscopic scoring systems in a population with high prevalence of portal hypertension: a prospective cohort study from Pakistan. J Clin Exp Hepatol Oakland K (2019) Risk stratification in upper gastrointestinal bleeding: scope, goals, and limitations. Clin Endosc 52(6):457–463 Laursen SB, Oakland K, Laine L, Bieber V, Marmo R, Redondo-Cerezo E et al (2021) ABC score: a new pre-endoscopic risk score for patients with upper gastrointestinal bleeding. Gut 70(5):999–1007 Saltzman JR, Tabak YP, Hyett BH, Sun X, Travis AC, Johannes RS (2011) A simple risk score accurately predicts in-hospital mortality, length of stay, and cost in acute upper gastrointestinal bleeding. Gastroenterology 140(1):S22 Stanley AJ, Ashley D, Dalton HR, Mowat C, Gaya DR, Thompson E et al (2009) Outpatient management of patients with low-risk upper gastrointestinal haemorrhage: multicentre validation and prospective evaluation. Lancet 373(9657):42–47 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 29 Apr, 2026 Reviewers agreed at journal 20 Apr, 2026 Reviewers invited by journal 09 Apr, 2026 Submission checks completed at journal 07 Apr, 2026 First submitted to journal 01 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9044443","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":620146109,"identity":"b0f6a13a-2dd1-41ba-81fd-fa89c47f27e5","order_by":0,"name":"Awny Ali Abdelrahman","email":"","orcid":"","institution":"Aswan University","correspondingAuthor":false,"prefix":"","firstName":"Awny","middleName":"Ali","lastName":"Abdelrahman","suffix":""},{"id":620146110,"identity":"1f2e2568-aca6-4382-9896-409f40e1c734","order_by":1,"name":"Aya AwadElkarim Mohamed Osman","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA90lEQVRIiWNgGAWjYBACNjBZwGDAz8x+8AGQycNHSAs/mDRgMJBs70k2AGlhI6RFsgGqxeDMATMJhL14gMGN5KcbfhjYGBvcSEir/JpjJ8PGwPzw0Q28WtLMbvYYpJlJ3kg8dlt2WzLQYWzGxjl4tSSY3eAxOGzDB7TltuQ2ZqAWHjZpfFrsb6R/u/nH4L8NA1BvseS2esJaDG7kmN3mMThgJgD0PuPHbYeJ0HLmTdltGYNkY1AgSzNuO87DxkzIL8fTt918U2Fn2A+Myo8/t1Xb87M3P3yMTwuDQAKCzcwDJvEpBwH+Awg24w9CqkfBKBgFo2BEAgAIyEyCGt2jLAAAAABJRU5ErkJggg==","orcid":"","institution":"Aswan University","correspondingAuthor":true,"prefix":"","firstName":"Aya","middleName":"AwadElkarim Mohamed","lastName":"Osman","suffix":""},{"id":620146111,"identity":"6004873e-0453-4799-bbe5-d30619ee7941","order_by":2,"name":"Sahar Mohamed Hassany","email":"","orcid":"","institution":"Assiut University","correspondingAuthor":false,"prefix":"","firstName":"Sahar","middleName":"Mohamed","lastName":"Hassany","suffix":""}],"badges":[],"createdAt":"2026-03-05 23:08:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9044443/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9044443/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107483236,"identity":"351ba15b-d1ca-45c5-8a0b-9f7058abe130","added_by":"auto","created_at":"2026-04-22 02:26:54","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":9751,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eROC curve analyses \u003c/strong\u003efor assessment of the best cut-off points of Blatchford and Rockall scores for discrimination between survivors and non-survivors.\u003c/p\u003e","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-9044443/v1/b7fb18642e62eb7dbf0015c9.png"},{"id":107254515,"identity":"ec843bf9-c974-46b0-bec9-db7062c012eb","added_by":"auto","created_at":"2026-04-19 12:02:18","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":6290,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eOdds ratios for mortality risk assessment after UGIB.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-9044443/v1/c797d91980f9ac43460758c2.png"},{"id":107485928,"identity":"1e339453-c8be-4798-91ae-aae7b35914af","added_by":"auto","created_at":"2026-04-22 02:36:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":748727,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9044443/v1/4f174a2a-9b20-4140-82e9-2adb1df4a916.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparative Accuracy of Rockall and Glasgow-Blatchford Scores in Predicting Outcomes of Acute Upper Gastrointestinal Bleeding: A Prospective Study at Upper Egypt","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAcute upper gastrointestinal bleeding (UGIB) accounts for approximately 75% of all cases of acute gastrointestinal bleeding and is one of the major emergencies worldwide. Its incidence is 11 cases per 10,000 population per year (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Despite the technological advancements, UGIB is still considered one of the most common medical emergencies that results in substantial morbidity and mortality, with reported mortality rates ranging from 2% to 15% worldwide.\u003c/p\u003e \u003cp\u003eIn cases of UGIB, time is of the essence. It requires timely assessment and triage of high-risk patients, followed by appropriate management and resource allocation (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRisk stratification was invented to aid clinical decision-making at presentation (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Among the most widely used is the Glasgow\u0026ndash;Blatchford Score (GBS). It\u0026rsquo;s main purpose is to determine management strategy, whether the patient needs an endoscopic intervention. Another score is the Rockall Score (RS), in which its purpose is to estimate the risk of rebleeding and mortality based on two main inputs which are the clinical data of the patients and the endoscopic data after the first endoscopy. Both scores are recommended in international guidelines and are routinely used in emergency departments and endoscopy units(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eData comparing the predictive performance of GBS and RS in Egyptian patients with UGIB remains limited, particularly in Upper Egypt, where liver disease burden is high. Evaluating these scores in a local population is essential to determine their applicability and to guide evidence-based triage and management strategies.\u003c/p\u003e \u003cp\u003eTherefore, the present study aimed to assess the credibility and effectiveness of both scores, GBS and RS, among Egyptian patients presenting with acute UGIB at Aswan University Hospital.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e \u003cstrong\u003eStudy Design\u003c/strong\u003e \u003cp\u003eA prospective observational study design, aiming to assess the predictive accuracy of the Glasgow\u0026ndash;Blatchford Score and Rockall Score in acute upper gastrointestinal bleeding patients.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eSetting and Participants\u003c/strong\u003e \u003cp\u003eThe study was carried out at the Department of Tropical Medicine and Gastroenterology, Aswan University Hospital, Upper Egypt between June 2025 till January 2026\u003c/p\u003e \u003c/p\u003e \u003cp\u003eA total of 150 consecutive adult patients (\u0026ge;\u0026thinsp;18 years) presenting with overt upper gastrointestinal bleeding were enrolled.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eInclusion and Exclusion Criteria:-\u003c/h2\u003e \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e \u003ch2\u003e\u003cb\u003e*Inclusion criteria\u003c/b\u003e:\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e\u0026bull; Adult patients (\u0026ge;\u0026thinsp;18 years)\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e\u0026bull; Presentation with clinical evidence of acute upper gastrointestinal bleeding\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e(hematemesis, melena, hematochezia suspected to be from an upper GI source )\u003c/p\u003e \u003cp\u003e \u003cb\u003e*Exclusion criteria\u003c/b\u003e were:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e\u0026bull; Lower gastrointestinal bleeding\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e\u0026bull; Occult gastrointestinal bleeding\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e\u0026bull; Patients who declined to provide informed consent\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eData Collection: -\u003c/b\u003e All enrolled patients underwent:\u003c/p\u003e \u003cp\u003eI - standardized clinical assessment upon admission, including detailed medical history, physical examination, and haemodynamic evaluation.\u003c/p\u003e \u003cp\u003eII- Laboratory investigations included\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eComplete blood count( CBC): red blood cells (RBCs), haemoglobin concentration (Hg ), Complete platelet count\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eBlood urea nitrogen, serum Creatinine.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eIII- Upper gastrointestinal endoscopy was performed after initial resuscitation according to standard hospital protocols. Endoscopic findings were classified as variceal or non-variceal bleeding sources.\u003c/p\u003e \u003cp\u003eIV- The Glasgow\u0026ndash;Blatchford Score was calculated at presentation using clinical and laboratory parameters before endoscopy. The Rockall Score was calculated after endoscopy using clinical and endoscopic variables.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e- \u003cb\u003eOutcomes\u003c/b\u003e: Primary outcomes were in-hospital mortality, rebleeding rates, and the need for clinical interventions (blood transfusion or surgery).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e- \u003cb\u003eStatistical Analysis\u003c/b\u003e: Data were analysed using IBM SPSS v26.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eSensitivity, specificity, and area under the ROC curve (AUC) were calculated to evaluate the predictive power and determine the best cut-off points for the Glasgow\u0026ndash;Blatchford and Rockall scores. Additionally, we ran a logistic regression analysis to identify independent factors that predict mortality. A p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered to be statistically significant. To compare survivors against non-survivors, we used Chi-square or Fisher\u0026rsquo;s exact tests for categorical variables and the Mann\u0026ndash;Whitney U test for non-parametric continuous variables.\u003c/p\u003e \u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eEthical considerations\u003c/span\u003e: The study protocol was approved by the Institutional Review Board of Aswan University. The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from all participants before enrolment.( IRB No: Asw/Uni/923/5/24).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e\u0026minus;\u0026thinsp;150 patients were included in the study. All the patients with acute UGIB according to the inclusion criteria. The median age was found to be 60 years (range: 18\u0026ndash;90 years). Regarding the gender distribution, 90 patients (60%) were male. (\u003cb\u003eTable\u0026nbsp;1\u003c/b\u003e ) demonstrated that the in-hospital mortality was 5.3% (n\u0026thinsp;=\u0026thinsp;8 patients) .\u003c/p\u003e\n\u003ch3\u003eClinical and Laboratory Findings :-\u003c/h3\u003e\n\u003cp\u003eNon survivors has significantly worse clinical outcomes compared to survivors\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e-Rebleeding occurred in 83.3% of non-survivors compared with 2.8% of survivors (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e-Variceal bleeding accounted for 28.6% of the study populations significantly more common among non-survivors than survivors (87.5% vs. 25.4%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e- Additionally, non survivors had significantly lower platelet counts (125.5 vs. 230 \u0026times;10⁹/L, p\u0026thinsp;=\u0026thinsp;0.02).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e-The need for blood transfusion ( 87.5% vs 38.9%, p\u0026thinsp;=\u0026thinsp;0.002) and endoscopic intervention( 66.7%vs26.7%, p\u0026thinsp;=\u0026thinsp;0.02) was significantly higher in non-survivors.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eRisk scores :-\u003c/b\u003e \u003c/p\u003e \u003cp\u003e- The precise calculations for the performance of these tests based on the above-defined cut-offs are shown in \u003cb\u003e(Table\u0026nbsp;2, Fig.\u0026nbsp;1).\u003c/b\u003e\u003c/p\u003e \u003cp\u003eRockall and Glasgow\u0026ndash;Blatchford scores were significantly higher among non-survivors. The median Rockall score was 6.5 (IQR: 5.5\u0026ndash;7) in non-survivors compared with 4 (IQR: 1\u0026ndash;5) in survivors (p\u0026thinsp;=\u0026thinsp;0.001). Similarly, the median Glasgow\u0026ndash;Blatchford score was significantly higher was 15 (IQR 13.5\u0026ndash;16) in non-survivors vs. 10 (IQR 6\u0026ndash;13) in survivors ,( p\u0026thinsp;=\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eThe ROC curves showed that a Blatchford score rounded to13 (\u0026gt;\u0026thinsp;12.5) was associated with a risk of in-hospital mortality with 85.6% sensitivity and 100% specificity (AUC\u0026thinsp;=\u0026thinsp;0.829). A Rockall score rounded to 5(\u0026gt;\u0026thinsp;4.5 ) was determined to be the best cut-off point associated with a fatal outcome, with 82.7% sensitivity and 100% specificity (AUC\u0026thinsp;=\u0026thinsp;0.827).\u003c/p\u003e\n\u003ch3\u003e-Prediction of Mortality :-\u003c/h3\u003e\n\u003cp\u003eThe results of the univariate and multivariate logistic regression are shown in \u003cb\u003e( Table\u0026nbsp;3, Fig.\u0026nbsp;2)\u003c/b\u003ewith the following variables estimated as the main drivers of fatal outcomes: lower SBP: OR\u0026thinsp;=\u0026thinsp;1.32 (95% CI: 0.23\u0026ndash;7.47), higher heart rate: OR\u0026thinsp;=\u0026thinsp;1.1 (95% CI: 1.04\u0026ndash;1.15), low platelets count OR\u0026thinsp;=\u0026thinsp;1.1 (95% CI: 0.97\u0026ndash;1.3), rebleeding: OR\u0026thinsp;=\u0026thinsp;13.8 (95% CI: 11.5\u0026ndash;41.1), variceal EGD finding: OR\u0026thinsp;=\u0026thinsp;2.9 (95% CI: 1.7\u0026ndash;6.2), RS: OR: 2.09 (95% CI: 1.21\u0026ndash;3.58), and GBS: OR\u0026thinsp;=\u0026thinsp;1.54 (95% CI: 1.09\u0026ndash;2.15). Higher Glasgow\u0026ndash;Blatchford and Rockall scores were also independently associated with increased mortality risk. Rebleeding remained the strongest independent prediction of morality\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(1): Clinical, lab, and endoscopic features between survivors and non-survivors.\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eSurvivors\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;142\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eNon-survivors\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;8\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTest of significance\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e60 (60\u0026ndash; 62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e60(60\u0026ndash;62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ez=-0.23\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.81\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNo.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eNo.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e62.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003ex2\u0026thinsp;=\u0026thinsp;0.11\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.73\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eComorbidities\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNo.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eNo.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePresent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e75.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003ex2\u0026thinsp;=\u0026thinsp;3.12\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP\u0026thinsp;=\u0026thinsp;0.07\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbsent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eClinical manifestation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNo.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eNo.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHematemesis+ melena\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e87.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ex2\u0026thinsp;=\u0026thinsp;7.89\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.005*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHematemesis only\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ex2\u0026thinsp;=\u0026thinsp;2.07\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.15\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMelena only\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ex2\u0026thinsp;=\u0026thinsp;1.38\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.20\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLab measures\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatinine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e1.7 (0.8\u0026ndash;1.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e1.8 (0.9\u0026ndash;2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ez\u0026thinsp;=\u0026thinsp;1.48\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.13\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e39 (29\u0026ndash; 64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e65 (15\u0026ndash; 90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ez\u0026thinsp;=\u0026thinsp;1.46\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.14\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHaemoglobin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e8.9 (\u003cspan additionalcitationids=\"CR7 CR8 CR9 CR10\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e6.9 (6.8\u0026ndash;71.)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ez=-1.20\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.02\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlatelets\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e230 (150\u0026ndash;293)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e126 (80\u0026ndash;193)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ez=-2.27\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.02*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEGD finding\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNo.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eNo.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariceal EGD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e25.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e87.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ex2\u0026thinsp;=\u0026thinsp;17.2\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eComplications\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNo.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eNo.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRebleeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e2.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e75.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ex2\u0026thinsp;=\u0026thinsp;59\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTransfusion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e38.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e87.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ex2\u0026thinsp;=\u0026thinsp;8.8\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.002*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIntervention\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNo.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eNo.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEndoscopic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e26.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e66.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ex2\u0026thinsp;=\u0026thinsp;5.3\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.02*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eData are presented as frequency (percentage) or median (IQR). \u003cem\u003ex2\u003c/em\u003e: Chi-square test, z: Mann-Whitney u-test, *: significant if (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(2): Blatchford and Rockall scores between survivors and non-survivors.\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRockall score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurvivors\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;142\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-survivors\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;8\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTest of significance\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (\u003cspan additionalcitationids=\"CR2 CR3 CR4\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.5 (5.5\u0026ndash;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ez\u0026thinsp;=\u0026thinsp;3.02\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGBS score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (\u003cspan additionalcitationids=\"CR7 CR8 CR9 CR10 CR11 CR12\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (13.5\u0026ndash;16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ez=-2.94\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eData are presented as median (IQR), z: Mann-Whitney U-test, *: significant if (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(3): Logistic regression and ORs for mortality risk assessment after UGIB.\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabc\" border=\"1\"\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ereferance\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ecategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eLower\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eUpper\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003eLower\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eUpper\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePer 1 year\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.81\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003emale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.75\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSBP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePer1 mmHg\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.002*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.38\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHeart rate\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePer 1 bpm\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.002*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.24\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHaematocrit\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePer 1%\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.15\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUrea\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePer 1mg/dl\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.68\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCreatinine\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePer 1mg/dl\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.95\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePlatelets\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePer 10x103\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.03*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.88\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRebleeding\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eabsent\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e127.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003eP\u0026thinsp;=\u0026thinsp;0.02*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eComorbidities\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eabsent\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.10\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMelena\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eabsent\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.29\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVariceal EGD\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNon variceal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.01*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.37\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGBS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePer 1 point\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.02*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePer 1 point\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.007*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e52.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.01*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e*: significant if (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), SBP: systolic blood pressure, GBS: Blatchford Score, RS: Rockall score\u003c/p\u003e \u003cp\u003e \u003cb\u003eFigure (1): ROC curve analyses\u003c/b\u003e for assessment of the best cut-off points of Blatchford and Rockall scores for discrimination between survivors and non-survivors.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eFigure (2)\u003c/b\u003e: \u003cb\u003eOdds ratios for mortality risk assessment after UGIB.\u003c/b\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e-The present prospective study evaluated the performance of the Glasgow\u0026ndash;Blatchford Score and Rockall Score among Egyptian cases presenting with acute UGIB. The findings demonstrate that both scoring systems are reliable tools for risk stratification; however, each score showed distinct strengths. The Glasgow\u0026ndash;Blatchford Score was more sensitive in predicting the need for clinical intervention, while the Rockall Score showed superior performance in predicting in-hospital mortality(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e-The mortality rate was found to be 5.3%, which is comparable to rates reported in international studies which range from 2% to 10%. similar finding were reported by Stanley et al 2000. Non-survivors were characterized by hemodynamic instability, higher rebleeding rates, lower platelet counts, and a markedly higher prevalence of variceal bleeding. These findings highlight the substantial impact of underlying chronic liver disease and portal hypertension on UGIB outcomes in Upper Egypt.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e-Our results are congruent with previous studies that found that the Glasgow\u0026ndash;Blatchford Score is highly sensitive for identifying patients requiring hospital-based intervention (9.10). Large multi-centre studies have shown that GBS performs well in early triage and may safely identify low-risk patients suitable for outpatient management. In contrast, the Rockall Score incorporates both clinical and endoscopic variables, which likely explains its superior ability to predict mortality in the post-endoscopic setting (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Rebleeding was the most significant predictor of death (OR\u0026thinsp;=\u0026thinsp;17.4), highlighting the importance of early endoscopic control.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e-Although both scores demonstrated good discriminatory ability, their performance may be influenced by regional differences in disease patterns. In Egypt, the high prevalence of chronic liver disease may limit the predictive accuracy of scoring systems originally developed in predominantly non-variceal Western populations. Nevertheless, our findings suggest that both GBS and Rockall scores remain clinically useful in this setting when applied appropriately. (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e-In our prospective cross-sectional study, both scores showed moderate correlation, reflecting their complementary roles. Comparable results were reported in studies from the UK, Europe, and Asia (\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). However, some studies suggested that newer scores, such as AIMS65 or ABC, may provide higher mortality prediction accuracy (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e \u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eThe strengths of this study\u003c/span\u003e are evident in its prospective methodology with standardized data collection, and focus on an Egyptian population that is underrepresented in the current literature.\u003c/p\u003e\n\u003ch3\u003eLimitations\u003c/h3\u003e\n\u003cp\u003eThe limitations of the study are as follow, First, it was conducted at single center, which may limit the generalization of the finding. Second, the sample size was relatively small, particularly the number of mortality events which may affect the robustness of multivariate analysis. Additionally other established scoring systems such as (AIM65, ABC) were not included for comparison, Finally, regional differences in disease patterns, particularly the high prevalence of chronic liver disease in Egypt, may influence the performance of these scoring system\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOur study demonstrated that both the Glasgow- Blatchford and Rockall scores are useful tools for risk stratification in patients with acute UGIB. Both scores show good discriminatory ability in identifying high- risk patients.\u003c/p\u003e \u003cp\u003eThe Glasgow- Blatchford Score was more sensitive in predicting the need for clinical intervention, whereas the Rockall showed better performance in predicting mortality.\u003c/p\u003e \u003cp\u003eHowever, these findings should be interpreted in light of study limitations. Further large \u0026ndash; scale, multi center studies are recommended to validate the results and compare these scores with new risk stratification tools.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eRecommendations\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eImplementation: Routine use of GBS and RS may be considered in emergency units to aid in risk stratification.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eTriage: Patients with GBS\u0026thinsp;\u0026gt;\u0026thinsp;12.5 or RS\u0026thinsp;\u0026gt;\u0026thinsp;4.5 should be considered for closer monitoring and early interventions .\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eFuture Research: Further large-scale studies in Upper Egypt are needed to evaluate newer scoring systems like the ABC or NEWS scores.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eA.A.A. and A.A.M. conceptualized and designed the study.A.A.M. and S.M.H. collected the clinical and laboratory data. A.A.M wrote the main manuscript Text A.A.A. performed the upper gastrointestinal endoscopies and documented the findings.A.A.M. performed the statistical analysis and interpreted the data. A.A.A. and A.A.M. drafted the manuscript. S.M.H. critically revised the manuscript for important intellectual content.All authors reviewed and approved the final version of the manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data that support the findings of this study are available from the corresponding author upon reasonable request\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLaine L, Barkun AN, Saltzman JR, Martel M, Leontiadis GI (2021) ACG clinical guideline: upper gastrointestinal and ulcer bleeding. Am J Gastroenterol 116(5):899\u0026ndash;917\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKulendran K, Pecoraro A, Bashir S (2023) Acute upper gastrointestinal bleeding: an update. InnovAiT 16(11):630\u0026ndash;635\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoschovos C, Tsipogiannis K, Konstantakis C, Michopoulos S et al (2023) Comparison of risk scoring systems in predicting clinical outcomes in upper gastrointestinal bleeding: a systematic review and network meta-analysis. J Gastroenterol Hepatol 38(9):1443\u0026ndash;1455\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBarkun AN, Almadi M, Kuipers EJ, Laine L, Sung J, Tse F et al (2019) Management of nonvariceal upper gastrointestinal bleeding: guideline recommendations from the international consensus group. Ann Intern Med 171(11):805\u0026ndash;822\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhan MY, Kamal F (2023) Risk stratification in upper gastrointestinal bleeding: a comprehensive review. World J Gastrointest Pharmacol Ther 14(4):55\u0026ndash;68\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSperanza R, Fugazza A, Bove V, Repici A, Anderloni A (2024) Risk stratification in acute upper gastrointestinal bleeding: a state-of-the-art review. Dig Liver Dis 56(2):189\u0026ndash;197\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBlatchford O, Murray WR, Blatchford M (2000) A risk score to predict need for treatment for upper gastrointestinal haemorrhage. Lancet 356:1318\u0026ndash;1321\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNazar S, McAvoy C, Stanley AJ (2023) Risk stratification and timing of endoscopy in upper gastrointestinal bleeding: an update. Frontline Gastroenterol 14(3):255\u0026ndash;261\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStanley AJ, Laine L, Dalton HR, Ngu JH, Schultz M, Abazi R et al (2011) Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicenter prospective study. BMJ 342:d458\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRockall TA, Logan RF, Devlin HB, Northfield TC (1996) Risk assessment after acute upper gastrointestinal haemorrhage. Gut 38:316\u0026ndash;321\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKamal F, Khan MA, Ali B (2023) Utility of pre-endoscopic scoring systems in a population with high prevalence of portal hypertension: a prospective cohort study from Pakistan. J Clin Exp Hepatol\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOakland K (2019) Risk stratification in upper gastrointestinal bleeding: scope, goals, and limitations. Clin Endosc 52(6):457\u0026ndash;463\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLaursen SB, Oakland K, Laine L, Bieber V, Marmo R, Redondo-Cerezo E et al (2021) ABC score: a new pre-endoscopic risk score for patients with upper gastrointestinal bleeding. Gut 70(5):999\u0026ndash;1007\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaltzman JR, Tabak YP, Hyett BH, Sun X, Travis AC, Johannes RS (2011) A simple risk score accurately predicts in-hospital mortality, length of stay, and cost in acute upper gastrointestinal bleeding. Gastroenterology 140(1):S22\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStanley AJ, Ashley D, Dalton HR, Mowat C, Gaya DR, Thompson E et al (2009) Outpatient management of patients with low-risk upper gastrointestinal haemorrhage: multicentre validation and prospective evaluation. Lancet 373(9657):42\u0026ndash;47\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"the-egyptian-journal-of-internal-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [The Egyptian Journal of Internal Medicine](https://ejim.springeropen.com/)","snPcode":"43162","submissionUrl":"https://submission.springernature.com/new-submission/43162/3","title":"The Egyptian Journal of Internal Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Upper gastrointestinal bleeding, Glasgow-Blatchford score, Rockall score, risk stratification, mortality prediction","lastPublishedDoi":"10.21203/rs.3.rs-9044443/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9044443/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e \u0026nbsp;Acute upper gastrointestinal bleeding (UGIB) is a time-sensitive emergency condition associated with significant morbidity and mortality where timely intervention and accurate risk assessment are very important.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAim: \u003c/strong\u003eTo assess and compare the efficiency of the Glasgow-Blatchford Score (GBS) with the Rockall Score (RS) in predicting mortality, morbidity and clinical outcomes among Egyptian patients presenting with acute UGIB.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e This prospective observational study’s sample size was 150 overt UGIB patients admitted to Aswan University Hospital. Data collection included clinical, laboratory, and endoscopic data. The assessed outcomes include in-hospital mortality rates, rebleeding events, and the need for intervention. Receiver operating characteristic (ROC) curve analysis and logistic regression were used to assess the predictive performance of both scores( GBS \u0026amp; Rockall).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Overall, the first outcome, which was in-hospital mortality, was found to be 5.3%. Mortality cases had significantly higher rates of adverse events including rebleeding, variceal bleeding, and haemodynamic instability.\u003c/p\u003e\n\u003cp\u003eThe Glasgow–Blatchford Score demonstrated high sensitivity for predicting the need for intervention (91.4%). ROC analysis identified a GBS cut-off value of \u0026gt;12.5 for mortality prediction (AUC = 0.829), while a Rockall score \u0026gt;4.5 was the optimal threshold for mortality discrimination (AUC = 0.827). Rebleeding was the strongest independent predictor of mortality (OR = 17.4, p = 0.02).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Both Glasgow–Blatchford and Rockall scores are reliable tools for risk stratification in Egyptian patients with UGIB. A GBS \u0026gt;12.5 and RS \u0026gt;4.5 are critical thresholds for intensive care and urgent endoscopy. A GBS is superior for identifying patients requiring intervention, whereas the Rockall score better predicts mortality. Routine implementation of both scores may improve early clinical decision-making and patient outcomes.\u003c/p\u003e","manuscriptTitle":"Comparative Accuracy of Rockall and Glasgow-Blatchford Scores in Predicting Outcomes of Acute Upper Gastrointestinal Bleeding: A Prospective Study at Upper Egypt","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-19 12:02:14","doi":"10.21203/rs.3.rs-9044443/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-29T09:31:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"213620918596919539398257811922312462075","date":"2026-04-20T18:36:09+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-09T08:17:01+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-07T06:51:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"The Egyptian Journal of Internal Medicine","date":"2026-04-01T17:47:47+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"the-egyptian-journal-of-internal-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [The Egyptian Journal of Internal Medicine](https://ejim.springeropen.com/)","snPcode":"43162","submissionUrl":"https://submission.springernature.com/new-submission/43162/3","title":"The Egyptian Journal of Internal Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"84bb1b26-1ee7-4ba7-9404-08e5287708a7","owner":[],"postedDate":"April 19th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-04-29T09:31:38+00:00","index":16,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-19T12:02:14+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-19 12:02:14","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9044443","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9044443","identity":"rs-9044443","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}