Prognostic Utility of Glucose-to-Potassium, Lactate-to-Albumin, and Uric Acid-to-Albumin Ratios for Adverse Outcomes in Acute Upper Gastrointestinal Bleeding: A Retrospective Cohort Study

Prognostic Utility of Glucose-to-Potassium, Lactate-to-Albumin, and Uric Acid-to-Albumin Ratios for Adverse Outcomes in Acute Upper Gastrointestinal Bleeding: A Retrospective Cohort Study | 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 Prognostic Utility of Glucose-to-Potassium, Lactate-to-Albumin, and Uric Acid-to-Albumin Ratios for Adverse Outcomes in Acute Upper Gastrointestinal Bleeding: A Retrospective Cohort Study Can Gökay Yıldız, Göknur Yıldız, Fatih Alper Ayyıldız This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8502924/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background Acute upper gastrointestinal bleeding (UGIB) is a life-threatening emergency with an annual incidence of 50–150 per 100,000 and ~ 10% in-hospital mortality. While scores like AIMS65, Glasgow-Blatchford (GBS), and Rockall aid risk stratification, their limitations in resource-limited settings highlight the need for simple, laboratory-derived biomarkers. This study evaluates admission glucose-to-potassium (GPR), lactate-to-albumin (LAR), and uric acid-to-albumin (UAR) ratios for predicting mortality, ICU admission, and intubation in endoscoped emergency department (ED) patients with UGIB. Methods In this retrospective cohort study at a tertiary hospital (July 2024–July 2025), 472 adults (≥ 18 years) with confirmed UGIB (hematemesis/melena/hematochezia) undergoing endoscopy were included. Baseline demographics, vitals, labs, and scores (AIMS65, GBS, Rockall) were recorded. Ratios were calculated from admission labs. Outcomes were in-hospital mortality, ICU admission, and intubation. Non-normal data were analyzed via Mann-Whitney U and Spearman correlations; predictive performance via ROC curves and DeLong's test (SPSS v20.0; p < 0.05). Results Median age was 71 years (62.3% male); comorbidities included hypertension (47.5%) and diabetes (26.7%). Mortality occurred in 11.2%, ICU admission in 78.0%, and intubation in 11.4%. Non-survivors had higher LAR (0.130 vs. 0.049, p < 0.001) and UAR (0.203 vs. 0.157, p < 0.001). LAR correlated positively with scores (r = 0.414–0.424, p < 0.001). For mortality, LAR AUC was 0.79 (cutoff 0.05; sensitivity 79.2%, specificity 64.2%), matching AIMS65 (0.79) and outperforming GBS (0.65) and Rockall (0.75). Similar for intubation (LAR AUC 0.79). GPR/UAR showed modest AUCs (0.59–0.66). Conclusions LAR provides AIMS65-equivalent prognostic accuracy for mortality and intubation in UGIB, offering a cost-effective adjunct for ED triage. Integrating these ratios may optimize resource allocation and outcomes in high-risk patients. Upper Gastrointestinal Bleeding Glucose-to-Potassium Ratio Lactate-to-Albumin Ratio Uric Acid-to-Albumin Ratio Risk Stratification Mortality Prediction Figures Figure 1 Figure 2 Figure 3 Introduction Acute upper gastrointestinal bleeding (UGIB) is considered a common and potentially life-threatening emergency, with an estimated annual incidence of 50–150 cases per 100,000 population and an in-hospital mortality rate of approximately 10%; this rate remains unchanged despite advances in endoscopic and pharmacological treatments ( 1 , 2 ). This condition imposes a significant burden, particularly in emergency departments (EDs), where rapid risk stratification is essential to guide decisions on hospitalization, transfusion, and urgent endoscopy ( 3 ). Hemodynamic instability at presentation is observed in 20–30% of cases and increases the risk of multiorgan failure and death ( 4 ). Therefore, effective prognostic tools that identify high-risk patients for intensive care unit (ICU) admission or early intervention are critically important; they also enable safe triage of low-risk individuals for outpatient management. Various validated scoring systems have been developed to predict clinical outcomes in UGIB, including the need for intervention, rebleeding, and mortality. The Glasgow-Blatchford Score (GBS) is widely used for pre-endoscopic risk assessment, emphasizing clinical and laboratory parameters such as blood urea nitrogen and hemoglobin to identify patients requiring hospital admission or endoscopic therapy; however, its performance in predicting mortality is modest ( 5 , 6 ). The AIMS65 score, derived from ED cohorts, incorporates age, International Normalized Ratio (INR), altered mental status, systolic blood pressure, and comorbidities, demonstrating superior accuracy for in-hospital mortality prediction compared to GBS in some settings; however, its specificity for endoscopic needs is limited ( 7 , 8 ). The Rockall score, particularly its pre-endoscopic version, integrates endoscopic findings with clinical variables to forecast rebleeding and mortality, outperforming GBS in high-risk variceal bleeds but showing variable discriminatory power in nonvariceal UGIB ( 9 , 10 ). Recent comparative studies highlight the complementary strengths of these tools—AIMS65 for mortality, GBS for intervention, and Rockall for comprehensive risk—but underscore the need for integrated biomarkers to enhance overall predictive accuracy, especially in resource-limited ED environments ( 11 ). Beyond traditional scores, laboratory-derived ratios provide simple and cost-effective prognostic insights by reflecting underlying metabolic, inflammatory, and hypoxic derangements in critically ill patients. The glucose-to-potassium ratio (GPR) has gained attention as a marker of metabolic stress and electrolyte imbalance, correlating with 28-day mortality in sepsis and predicting poor outcomes in traumatic brain injury, where elevated ratios are independent of glucose alone ( 12 ). Similarly, the lactate-to-albumin ratio (LAR) integrates tissue hypoperfusion (lactate) with nutritional/inflammatory status (albumin), demonstrating strong associations with ICU mortality in sepsis and signaling heightened risk of organ failure in acute-on-chronic liver failure, where ratios > 0.5 are indicative ( 13 , 14 ). The uric acid-to-albumin ratio (UAR), reflective of oxidative stress and hypoalbuminemia, has been linked to short-term mortality in acute kidney injury and atrial fibrillation recurrence, positioning it as a novel indicator of systemic inflammation in acute illnesses ( 15 , 16 ). Despite these promising applications, the utility of GPR, LAR, and UAR in UGIB remains underexplored; to date, no studies have examined their correlations with AIMS65, GBS, and Rockall scores in endoscoped ED patients. This study aims to evaluate the prognostic value of admission GPR, LAR, and UAR for mortality, ICU admission, and intubation in patients presenting to the ED with UGIB who undergo endoscopy, and to assess their associations with AIMS65, GBS, and Rockall scores. By addressing this gap, we seek to propose accessible, laboratory-based adjuncts that could refine risk stratification and improve outcomes in this high-risk population. Methods Study Design and Setting This study was conducted in the emergency department (ED) of a tertiary care hospital between July 1, 2024, and July 31, 2025. Individuals aged 18 years or older who presented to the emergency department with manifestations consistent with gastrointestinal hemorrhage—namely, hematemesis, melena, or hematochezia—underwent endoscopic assessment at our institution and were thereafter admitted to either the general medical ward or the intensive care unit (ICU) for inclusion in this study. Pertinent clinical and demographic parameters were documented at the index presentation. Suspected cases of upper gastrointestinal bleeding (UGIB) were formally verified by a consulting gastroenterologist subsequent to the initial clinical suspicion in the emergency department. Determinations regarding ICU admission were rendered by the gastroenterologist, informed by established selection criteria predicated on the patients' hemodynamic derangements and propensity for recurrent hemorrhage, with subsequent ratification by the ICU specialist. Accordingly, ICU admissions for eligible patients were adjudicated collaboratively by the gastroenterologist and ICU specialist, in strict conformity with institutional guidelines governing intensive care utilization. Patients with terminal cancer, as well as those with concomitant diagnoses potentially precipitating hospitalization independently of acute gastrointestinal bleeding, were excluded from the study due to their capacity to confound mortality outcomes. Additionally, individuals transferred to external facilities—owing to the potential disruption of clinical follow-up—were excluded. The study protocol received approval from the Institutional Ethics Committee (Approval No. : ESH/BAEK 2025/171), and informed consent was obtained from all participants in accordance with the Declaration of Helsinki. Clinical and Laboratory Evaluation Demographic characteristics of the patients (age and sex), mental status, comorbidities, were systematically documented. Vital signs assessed at the emergency department triage station upon presentation—namely systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, oxygen saturation and mean blood pressure (MBP)—were recorded. Venous blood specimens were procured from all study participants at presentation and subjected to comprehensive biochemical and hematological evaluations via automated instrumentation, specifically the Cell-Dyn Ruby Hematology Analyzer for complete blood count (CBC) determinations and the Architect c8000 platform for biochemical assays. The baseline characteristics of the patients included in the study, along with the laboratory data obtained during their emergency department evaluation, were used to calculate the glucose-to-potassium ratio (GPR), lactate-to-albumin ratio (LAR), and uric acid-to-albumin ratio (UAR), AIMS65 score, Glasgow Blatchford score (GBS), and Rockall score. Outcome Measured Adverse prognostic endpoints were defined as the requirement for endotracheal intubation, admission to the intensive care unit (ICU), and in-hospital mortality. In the study cohort, the predictive efficacies of the glucose-to-potassium ratio (GPR), lactate-to-albumin ratio (LAR), and uric acid-to-albumin ratio (UAR) in forecasting these adverse outcomes were comparatively evaluated against the AIMS65, GBS, and Rockall scores. ICU admission was operationally defined as either direct transfer from the emergency department or subsequent in-hospital relocation from the ward due to clinical deterioration. Statistical Analysis Continuous variables with non-normal distributions were presented as median [interquartile range (IQR)]. Categorical variables were expressed as percentages. Data normality was evaluated using the Shapiro-Wilk test, and homogeneity of variances between groups was assessed with Levene's test. Categorical variables were analyzed using the chi-square test. For comparisons between the two groups, non-normally distributed continuous variables were evaluated with the Mann-Whitney U test. Spearman correlation analysis was utilized for evaluating correlations between GPR, LAR, UAR results and other variables. The ideal cutoff value, along with sensitivity and specificity for the GPR, LAR and UAR, was determined using receiver operating characteristic (ROC) curve analysis. To evaluate the comparative discriminative capacities, the areas under the receiver operating characteristic (ROC) curves for the GPR, LAR and UAR were juxtaposed via DeLong's test. Furthermore, the optimal threshold values for each metric were derived employing the Youden index. Statistical significance was defined as p < 0.05. All analyses were conducted using SPSS version 20.0 (IBM Corp., Armonk, NY, USA). Results A total of 472 patients were analyzed, with 294 (62.3%) male and a median age of 71 (60–81) years. Hypertension (47.5%), diabetes (26.7%), and malignancy (9.7%) were common comorbidities. ICU admission occurred in 368 (78.0%) patients, intubation in 54 (11.4%), and in-hospital mortality in 53 (11.2%) (Table 1 ). Table 1 Baseline Characteristics of the Study Population (n = 472) Number (n = 472) Age, year 71 (60–81) Sex, male 294 (62.3%) HT 224 (47.5%) DM 126 (26.7%) Malignancy 46 (9.7%) CLF 27 (5.7%) CHF 23 (4.9%) CAD 186 (39.4%) CVD 87 (18.4%) CRF 36 (7.6%) GCS 15 ( 15 – 15 ) AIMS65 1 (0–2) GBS 9 ( 5 – 12 ) ROCKALL 5 ( 3 – 6 ) GPR 30.2 (25.0-39.5) LAR 0.051 (0.035–0.081) UAR 0.162 (0.118–0.220) ICU 368 (78.0%) Intubation 54 (11.4%) Mortality 53 (11.2%) HT: Hypertension, DM: Diabetes Mellitus, CLF: Chronic liver failure, CHF: Chronic heart failure, CAD: Coronary artery disease, CVD: Cerebrovascular disease, CRF: Chronic renal failure, GCS: Glasgow coma scale, GBS: Glasgow Blatchford Score, GPR: Glucose-to-potassium ratio, LAR: Lactate-to-albumin ratio, UAR: Uric acid-to-albumin ratio, ICU: Intensive care unit Non-survivors were older [77 years (69.5–84.5) vs. 70 years, 59–80; p = 0.001] and had lower systolic blood pressure [110 mmHg (80–138) vs. 121 mmHg (101–132), p = 0.013], higher heart rate [98 bpm (84.5–106.0) vs. 86 bpm (78–98), p < 0.001], higher lactate [3.1 mmol/L (1.6–5.5) vs. 1.7 mmol/L (1.2–2.4), p < 0.001], lower hemoglobin [8.6 g/dL (7.0-10.6) vs. 9.9 g/dL (7.6–12.2), p = 0.009], and lower albumin [30.0 g/L (24.5–32.5) vs. 35.9 g/L (30.6–41.0), p < 0.001]. Risk scores were higher in non-survivors: AIMS65 2 (1.5-3) vs. 1 (0–2), GBS 11 ( 8 – 14 ) vs. 8 ( 5 – 12 ), Rockall 6 ( 5 – 8 ) vs. 5 ( 3 – 6 ) (all p < 0.001) (Table 2 ). Table 2 Comparative Clinical and Laboratory Characteristics Between Survivors and Non-Survivors Survivor (n = 419) Non-survivor (n = 53) P value Age, year 70 (59–80) 77.0 (69.5–84.5) 0.001 SBP, mmHg 121 (101–132) 110 (80–138) 0.013 DBP, mmHg 70 (61–78) 64 (60–80) 0.091 MBP, mmHg 89.3 (76.3–95) 79.3 (66.7–96.5) 0.031 HR, bpm 86.0 (78–98) 98.0 (84.5–106.0) 0.001 Saturation, % 98.0 (96–99) 96.0 (93.0-97.5) < 0.001 GCS 15 ( 15 – 15 ) 15 ( 13 – 15 ) < 0.001 pH 7.39 (7.36–7.41) 7.39 (7.32–7.44) 0.797 Lactate 1.7 (1.2–2.4) 3.1 (1.6–5.5) < 0.001 Hgb, g/dl 9.9 (7.6–12.2) 8.6 (7.0-10.6) 0.009 Hct, % 30.2 (23.4–36.7) 28.7 (21.7–31.9) 0.017 MCV, fL 87.5 (82.6–91.6) 86.7 (81.3–91.5) 0.996 MCHC, g/dL 32.9 (31.6–33.9) 31.8 (31.1–33.6) 0.071 RBC, 10^6/µL 3.5 (2.8–4.2) 3.3 (2.4–3.6) 0.013 Platelet, 10^3/µL 228 (183–287) 252 (216–279) 0.173 Glucose, mg/dL 127 (107–163) 146 (118–182) 0.109 Potassium, mmol/L 4.3 (4.0-4.7) 4.3 (3.8–4.9) 0.721 BUN, mg/dL 28.7 (19.1–43.8) 33.5 (22.5–53.5) 0.133 Creatinine, mg/dL 0.99 (0.79–1.32) 0.98 (0.66–1.51) 0.589 ALT, U/L 14 ( 10 – 20 ) 15 ( 9 – 28 ) 0.558 AST, U/L 18 ( 15 – 26 ) 22 (15–52) 0.011 Uric acid, mg/dL 5.7 (4.3–7.4) 5.9 (4.4–7.8) 0.352 Albumin, g/L 35.9 (30.6–41.0) 30.0 (24.5–32.5) < 0.001 INR 1.1 (1.0-1.3) 1.2 (1.1–1.7) < 0.001 APTT, s 25.8 (22.8–29.3) 28.7 (26.6–40.3) < 0.001 GPR 30.0 (24.6–39.3) 33.2 (27.9–45.0) 0.039 LAR 0.049 (0.035–0.071) 0.130 (0.060–0.169) < 0.001 UAR 0.157 (0.117–0.212) 0.203 (0.163–0.254) < 0.001 AIMS65 1 (0–2) 2 (1.5-3) < 0.001 GBS 8 ( 5 – 12 ) 11 ( 8 – 14 ) < 0.001 Rockall 5 ( 3 – 6 ) 6 ( 5 – 8 ) < 0.001 SBP: Systolic blood pressure, DBP: Diastolic blood pressure, MBP: Mean blood pressure, HR: Heart rate, GCS: Glasgow coma scale, Hgb: Hemoglobin, Hct: Hematocrit, MCV: Mean corpuscular volume, MCHC: Mean Corpuscular Hemoglobin Concentration, RBC: Red blood cell, BUN: Blood urea nitrogen, ALT: Alanin aminotransferase, AST: Aspartate transferase, INR: International Normalized Ratio, APTT: Activated partial thromboplastin time, GPR: Glucose-to-potassium ratio, LAR: Lactate-to-albumin ratio, UAR: Uric acid-to-albumin ratio, GBS: Glasgow Blatchford Score The ratios were elevated in non-survivors: GPR 33.2 (27.9–45.0) vs. 30.0 (24.6–39.3) (p = 0.039); LAR 0.130 (0.060–0.169) vs. 0.049 (0.035–0.071) (p < 0.001); UAR 0.203 (0.163–0.254) vs. 0.157 (0.117–0.212) (p < 0.001). ICU patients were older [74 years (62–82), vs. 62 years (44–74); p < 0.001], had higher lactate [1.9 mmol/L (1.4–2.9) vs. 1.4 mmol/L (1.2–2.1), p = 0.001], lower hemoglobin [9.5 g/dL (7.1–11.1) vs. 11.9 g/dL (9.4–14.2), p < 0.001], and higher risk scores [GPR 31.0 (26.4–39.5) vs. 26.4 (21.9–39.8) (p = 0.002); LAR 0.056 (0.039–0.087) vs. 0.041 (0.030–0.056) (p < 0.001); UAR 0.168 (0.127–0.231) vs. 0.141 (0.100-0.192) (p < 0.001) (Table 3 ). Table 3 Comparative Characteristics Between Patients Not Requiring and Requiring Intensive Care Unit (ICU) Admission ICU (-) (n = 104) ICU (+) (n = 368) P value Age, year 62 (44–74) 74 (62–82) < 0.001 SBP, mmHg 126 (113–132) 119 (100–132) 0.003 DBP, mmHg 72 (67–79) 70 (60–76) 0.011 MBP, mmHg 90.7 (83.3–96.0) 86.2 (73.3–95.0) 0.001 HR, bpm 84 (76–89) 88 (79–101) < 0.001 Saturation, % 98 (97–99) 97 (96–98) < 0.001 GCS 15 ( 15 – 15 ) 15 ( 15 – 15 ) 0.006 pH 7.39 (7.37–7.42) 7.39 (7.35–7.43) 0.518 Lactate 1.4 (1.2–2.1) 1.9 (1.4–2.9) 0.001 Hgb, g/dl 11.9 (9.4–14.2) 9.5 (7.1–11.1) < 0.001 Hct, % 36.8 (28.3–42.2) 28.8 (22.6–33.5) < 0.001 MCV, fL 85.8 (82.0-91.1) 87.8 (82.7–92.1) 0.046 MCHC, g/dL 32.9 (31.4–34.1) 32.8 (31.4–33.8) 0.544 RBC, 10^6/µL 4.3 (3.3–4.9) 3.3 (2.6–3.9) < 0.001 Platelet, 10^3/µL 237 (201–294) 229 (180–287) 0.140 Glucose, mg/dL 114 (94–163) 132 (112–168) 0.002 Potassium, mmol/L 4.3 (4.1–4.7) 4.3 (4.0-4.7) 0.944 BUN, mg/dL 20.0 (14.0-28.9) 32.5 (20.2–50.1) < 0.001 Creatinine, mg/dL 0.88 (0.73–1.22) 1.01 (0.80–1.36) 0.013 ALT, U/L 16.0 (11.0-24.7) 13.0 (9.0–20.0) 0.005 AST, U/L 20 ( 15 – 26 ) 18 ( 14 – 29 ) 0.233 Uric acid, mg/dL 5.5 (4.1–7.1) 5.8 (4.5–7.6) 0.229 Albumin, g/L 40.1 (34.8–44.0) 33.4 (28.7–39.1) < 0.001 INR 1.0 (0.9–1.1) 1.1 (1.0-1.4) < 0.001 APTT, s 26.8 (23.6–30.8) 26.0 (22.8–29.9) 0.249 GPR 26.4 (21.9–39.8) 31.0 (26.4–39.5) 0.002 LAR 0.041 (0.030–0.056) 0.056 (0.039–0.087) < 0.001 UAR 0.141 (0.100-0.192) 0.168 (0.127–0.231) < 0.001 AIMS65 0 (0–1) 1 ( 1 – 2 ) < 0.001 GBS 4.0 (1.0–8.0) 10.0 (6.0-12.7) < 0.001 Rockall 3.0 (1.2-4.0) 5.0 (4.0–7.0) < 0.001 SBP: Systolic blood pressure, DBP: Diastolic blood pressure, MBP: Mean blood pressure, HR: Heart rate, GCS: Glasgow coma scale, Hgb: Hemoglobin, Hct: Hematocrit, MCV: Mean corpuscular volume, MCHC: Mean Corpuscular Hemoglobin Concentration, RBC: Red blood cell, BUN: Blood urea nitrogen, ALT: Alanin aminotransferase, AST: Aspartate transferase, INR: International Normalized Ratio, APTT: Activated partial thromboplastin time, GPR: Glucose-to-potassium ratio, LAR: Lactate-to-albumin ratio, UAR: Uric acid-to-albumin ratio, GBS: Glasgow Blatchford Score Intubated patients were older [76.5 years (68.7–84.2) vs. 70 years (59-80.2); p = 0.001], had higher lactate [2.9 mmol/L (1.6–5.3) vs. 1.7 mmol/L (1.2–2.4), p < 0.001], lower albumin [29.6 g/L (24.7–32.5) vs. 35.9 g/L (30.7–41.0), p < 0.001], and higher risk scores [GPR 33.2 (27.9–45.6) vs. 30.0 (24.6–39.3) (p = 0.027); LAR 0.119 (0.060–0.163) vs. 0.049 (0.034–0.071) (p < 0.001); UAR 0.200 (0.163–0.254) vs. 0.157 (0.117–0.211) (p < 0.001)] (Table 4 ). Table 4 Comparative Clinical Parameters Between Patients Not Requiring and Requiring Intubation Intubation (-) (n = 418) Intubation (+) (n = 54) P value Age, year 70.0 (59.0-80.2) 76.5 (68.7–84.2) 0.001 SBP, mmHg 121.5 (101.7–132) 109.0 (80.0-137.7) 0.009 DBP, mmHg 70 (61–78) 64 (60–80) 0.069 MBP, mmHg 89.5 (76.3–95.1) 78.0 (66.7–96.1) 0.021 HR, bpm 86 (78–98) 98.0 (84.7–106.0) 0.001 Saturation, % 98 (96–99) 96 (9–98) < 0.001 GCS 15 ( 15 – 15 ) 15 ( 13 – 15 ) < 0.001 pH 7.39 (7.36–7.42) 7.39 (7.33–7.44) 0.694 Lactate 1.7 (1.2–2.4) 2.9 (1.6–5.3) < 0.001 Hgb, g/dl 9.9 (7.6–12.2) 8.6 (7.1–10.6) 0.007 Hct, % 30.2 (23.4–36.7) 27.6 (21.8–31.9) 0.014 MCV, fL 87.5 (82.6–91.6) 86.5 (81.6–91.3) 0.905 MCHC, g/dL 32.9 (31.6–33.9) 31.9 (31.1–33.6) 0.083 RBC, 10^6/µL 3.5 (2.7–4.2) 3.3 (2.4–3.6) 0.011 Platelet, 10^3/µL 228 (183–287) 252.0 (217.5–282.0) 0.116 Glucose, mg/dL 127 (107–163) 147.0 (119.2–182.0) 0.074 Potassium, mmol/L 4.3 (4.0-4.7) 4.3 (3.8–4.9) 0.866 BUN, mg/dL 28.8 (19.0-43.8) 33.5 (22.5–52.8) 0.156 Creatinine, mg/dL 0.99 (0.79–1.32) 0.96 (0.66–1.40) 0.544 ALT, U/L 14.0 (10.0-20.2) 14.0 (9.0-26.5) 0.712 AST, U/L 18 ( 15 – 26 ) 22 (15–52) 0.019 Uric acid, mg/dL 5.7 (4.3–7.4) 5.8 (4.4–7.8) 0.421 Albumin, g/L 35.9 (30.7–41.0) 29.6 (24.7–32.5) < 0.001 INR 1.1 (1.0-1.3) 1.2 (1.1–1.6) < 0.001 APTT, s 25.7 (22.8–29.3) 28.7 (26.6–39.8) < 0.001 GPR 30.0 (24.6–39.3) 33.2 (27.9–45.6) 0.027 LAR 0.049 (0.034–0.071) 0.119 (0.060–0.163) < 0.001 UAR 0.157 (0.117–0.211) 0.200 (0.163–0.254) < 0.001 AIMS65 1 (0–2) 2 ( 1 – 3 ) < 0.001 GBS 8 ( 5 – 12 ) 11 ( 8 – 14 ) < 0.001 Rockall 5 ( 3 – 6 ) 6 ( 5 – 8 ) < 0.001 SBP: Systolic blood pressure, DBP: Diastolic blood pressure, MBP: Mean blood pressure, HR: Heart rate, GCS: Glasgow coma scale, Hgb: Hemoglobin, Hct: Hematocrit, MCV: Mean corpuscular volume, MCHC: Mean Corpuscular Hemoglobin Concentration, RBC: Red blood cell, BUN: Blood urea nitrogen, ALT: Alanin aminotransferase, AST: Aspartate transferase, INR: International Normalized Ratio, APTT: Activated partial thromboplastin time, GPR: Glucose-to-potassium ratio, LAR: Lactate-to-albumin ratio, UAR: Uric acid-to-albumin ratio, GBS: Glasgow Blatchford Score Correlations (Spearman) showed GPR had positive correlation with AIMS65 (r = 0.147, p = 0.001), GBS (r = 0.114, p = 0.013), and Rockall (r = 0.221, p < 0.001). LAR and UAR had positive correlations with all scores (all p < 0.001) and negative correlations with GCS (r=-0.183 to-0.208, p < 0.001) (Table 5 ). Table 5 Correlation Analysis Between GPR, LAR, and UAR Ratios and Risk Scores GPR LAR UAR AIMS65 GBS Rockall GCS GPR 1 LAR 0.248 < 0.001 1 UAR 0.080 0.081 0.383 < 0.001 1 AIMS65 0.147 0.001 0.414 < 0.001 0.438 < 0.001 1 GBS 0.114 0.013 0.314 < 0.001 0.391 < 0.001 0.486 < 0.001 1 Rockall 0.221 < 0.001 0.424 < 0.001 0.377 < 0.001 0.580 < 0.001 0.516 < 0.001 1 GCS -0.065 0.157 -0.208 < 0.001 -0.183 < 0.001 -0.475 < 0.001 -0.235 < 0.001 -0.295 < 0.001 1 GPR: Glucose-to-potassium ratio, LAR: Lactate-to-albumin ratio, UAR: Uric acid-to-albumin ratio, GBS: Glasgow Blatchford Score, GCS: Glasgow coma scale. ROC analyses (Table 6 , Figs. 1 – 3 ) for ICU admission yielded AUCs of 0.60 (GPR), 0.67 (LAR), 0.63 (UAR), 0.71 (AIMS65), 0.76 (GBS), and 0.77 (Rockall) (all p < 0.001 except GPR p = 0.002). For intubation: 0.59 (GPR, p = 0.027), 0.79 (LAR), 0.66 (UAR), 0.79 (AIMS65), 0.66 (GBS), 0.75 (Rockall) (all others p < 0.001). For mortality: 0.59 (GPR, p = 0.039), 0.79 (LAR), 0.66 (UAR), 0.79 (AIMS65), 0.65 (GBS), 0.75 (Rockall) (all others p 0.05) and outperformed GPR/UAR (p < 0.01). Table 6 ROC curve analysis of GPR, LAR, UAR, AIMS65, GBS, and Rockall score for predicting intubation, ICU admission and mortality Outcome Index Cutoff Sensitivity (%) Specificity (%) AUC (95% CI) P value ICU Admission GPR 25.9 78.0 50.0 0.60 (0.53–0.67) 0.002 LAR 0.05 60.6 63.5 0.67 (0.61–0.72) < 0.001 UAR 0.16 58.7 59.6 0.63 (0.57–0.69) < 0.001 AIMS65 0.5 78.5 55.8 0.71 (0.65–0.76) < 0.001 GBS 6.5 73.6 69.2 0.76 (0.71–0.82) < 0.001 Rockall 4.5 65.2 78.8 0.77 (0.72–0.82) < 0.001 Intubation GPR 32.0 59.3 58.1 0.59 (0.51–0.67) 0.027 LAR 0.05 79.6 64.4 0.79 (0.73–0.86) < 0.001 UAR 0.18 68.5 60.8 0.66 (0.59–0.73) < 0.001 AIMS65 1.5 74.1 69.1 0.79 (0.73–0.86) < 0.001 GBS 9.5 59.3 57.7 0.66 (0.58–0.73) < 0.001 Rockall 5.5 68.5 66.5 0.75 (0.69–0.81) < 0.001 Mortality GPR 32.0 58.5 58.0 0.59 (0.50–0.67) 0.039 LAR 0.05 79.2 64.2 0.79 (0.73–0.86) < 0.001 UAR 0.16 71.7 54.9 0.66 (0.59–0.74) < 0.001 AIMS65 1.5 75.5 69.2 0.79 (0.73–0.86) < 0.001 GBS 8.5 71.7 51.3 0.65 (0.58–0.73) < 0.001 Rockall 5.5 67.9 66.3 0.75 (0.69–0.81) < 0.001 ROC: Receiver Operating Characteristic, AUC: Area under the curve, ICU: Intensive care unit, GPR: Glucose-to-potassium ratio, LAR: Lactate-to-albumin ratio, UAR: Uric acid-to-albumin ratio, GBS: Glasgow Blatchford Score Discussion This study investigated the prognostic utility of admission glucose-to-potassium ratio (GPR), lactate-to-albumin ratio (LAR), and uric acid-to-albumin ratio (UAR) in predicting adverse outcomes—intensive care unit (ICU) admission, endotracheal intubation, and in-hospital mortality—in emergency department (ED) patients with acute upper gastrointestinal bleeding (UGIB) who underwent endoscopy. Our findings demonstrate that these simple laboratory-derived ratios, particularly LAR, offer valuable adjunctive insights into risk stratification, with LAR exhibiting discriminative performance comparable to established scores like AIMS65 for intubation and mortality prediction. While GPR and UAR showed modest associations, LAR's superior area under the receiver operating characteristic curve (AUC) values highlight its potential as a cost-effective biomarker in resource-constrained settings. These results extend prior evidence on metabolic and inflammatory ratios in critical illness, underscoring their relevance in UGIB where rapid, accessible tools are paramount for triaging high-risk patients ( 17 , 18 ). Each ratio reflects distinct facets of UGIB pathophysiology (metabolic stress, hypoperfusion, and oxidative damage), enabling individualized and combined use to enhance clinical decision-making; for instance, elevated LAR may signal urgent endoscopy needs, while GPR could indicate arrhythmia risk from electrolyte imbalances ( 19 , 20 ). The most striking observation was the robust prognostic performance of LAR, which matched AIMS65's AUC for predicting intubation and mortality, outperforming GBS and Rockall in these endpoints while demonstrating moderate discriminatory power for ICU admission. Elevated LAR in non-survivors, intubated patients, and ICU-admitted individuals reflects the interplay of tissue hypoperfusion (elevated lactate) and hypoalbuminemia as a surrogate for inflammation and nutritional depletion—hallmarks of UGIB severity ( 19 , 21 ). In our cohort, non-survivors had markedly higher lactate and lower albumin, driving LAR elevations that correlated moderately with risk scores, predicts 28-day mortality independent of SOFA scores and captures endothelial dysfunction and capillary leak in hypovolemic shock ( 22 , 23 ). Similarly, in acute-on-chronic liver failure—a common UGIB etiology—LAR thresholds signal multiorgan failure risk, mirroring our findings in variceal and nonvariceal bleeds ( 23 , 24 ). LAR's success stems from lactate's role as an early hypoxia marker in UGIB; for example, in nonvariceal bleeds, lactate > 2.5 mmol/L increases rebleeding risk, while albumin < 30 g/L indicates inflammatory response severity ( 25 , 26 ). Unlike AIMS65, which relies on clinical variables like altered mental status, LAR leverages universally available labs, enhancing its feasibility in EDs with limited staffing. However, its lower specificity for mortality and intubation suggests it may over-triage low-risk patients, a limitation shared with AIMS65 and warranting combination models for refined accuracy. In contrast, GPR exhibited weaker predictive value, and only borderline significance for intubation and mortality. While non-survivors and intubated patients had modestly higher GPR, its weak correlations with scores and lack of superiority over traditional tools echo prior studies in non-UGIB contexts. GPR's origins in sepsis and traumatic brain injury stem from hyperglycemia-induced potassium shifts exacerbating arrhythmias in stress states, where ratios > 30 independently predict 28-day mortality beyond glucose monotherapy ( 12 , 27 ). Yet, in UGIB, confounding factors like blood urea elevation (from hypovolemia) may dilute GPR's specificity, as seen in our data where glucose levels did not differ significantly between survivors and non-survivors, and potassium imbalances may be modulated by chronic comorbidities (e.g., diabetes) ( 28 , 29 ). Comparative analyses in ED cohorts with mixed shock etiologies report GPR AUCs for ICU needs; these are inferior to lactate alone, suggesting that UGIB's predominant hypovolemic mechanism amplifies electrolyte derangements less potently than septic hypermetabolism ( 27 ). GPR's clinical value lies particularly in subgroups with cardiac instability; in our cohort, GPR > 32 in hypertensive patients could increase arrhythmia risk and prioritize ECG monitoring ( 20 ). Nonetheless, GPR's simplicity—no need for albumin assays—positions it as a preliminary screen in austere environments, potentially integrated with GBS for intervention prediction, though prospective validation is needed to confirm its adjunctive role ( 30 , 31 ). UAR, reflective of oxidative stress via hyperuricemia coupled with hypoalbuminemia, displayed intermediate performance, with elevations in adverse groups and moderate score correlations. This builds on evidence from acute kidney injury and atrial fibrillation, where UAR > 0.20 forecasts 30-day mortality by indexing purine catabolism as a marker of ischemia-reperfusion injury in bleeding disorders ( 32 , 33 ). In UGIB, uric acid's rise may stem from gastrointestinal xanthine oxidase activation during hemorrhage-induced hypoxia, while albumin decline signals capillary permeability—synergistically elevating UAR in 58.7% of ICU cases at our cutoff ( 34 , 35 ). Our negative GCS correlations further implicate UAR in encephalopathy risk, akin to findings in decompensated cirrhosis where UAR predicts hepatic encephalopathy ( 36 ). Compared to LAR, UAR's lower AUCs likely arise from uric acid's bidirectional regulation (e.g., renoprotective at low levels), reducing its sensitivity in early UGIB ( 37 ). UAR's strength is evident in patients with renal comorbidity; here, combining UAR with creatinine rise elevates renal failure prediction AUC and guides nephroprotective strategies (e.g., hydration) in UGIB management ( 33 ). Still, its accessibility—using routine biochemistry—complements Rockall's endoscopic integration, potentially improving post-endoscopy rebleeding forecasts in nonvariceal cases ( 38 , 39 ). Clinically, incorporating LAR into emergency department protocols can help regulate ICU admission rates, reduce unnecessary hospitalizations, and prevent delays in situations requiring intubation. GPR and UAR, on the other hand, provide targeted monitoring in subgroups with high mortality rates. This study was conducted at a single center with a cohort of 472 patients, which may limit the generalizability of the findings to diverse populations or healthcare settings. Additionally, the mandatory endoscopy requirement could introduce selection bias, potentially excluding milder cases that did not proceed to invasive evaluation. The lack of outpatient follow-up data represents another constraint, as it might lead to an underestimation of post-discharge rebleeding events. While confounders such as chronic liver failure (observed in 5.7% of participants) were common, our exclusion criteria effectively minimized bias related to terminal illnesses. To address these gaps, prospective multicenter studies are recommended to confirm the proposed cutoffs through serial biomarker assessments and to investigate machine learning approaches for tailoring risk prediction to individual patient profiles. Conclusion This study has demonstrated the prognostic value of GPR, LAR, and UAR in patients with acute UGIB. In particular, LAR exhibits discriminative performance equivalent to the AIMS65 score in predicting intubation and mortality, emerging as a cost-effective biomarker in resource-limited emergency department settings. While GPR and UAR provide modest associations, LAR's structure, which integrates tissue hypoperfusion and inflammatory response, strengthens risk stratification. These ratios, in addition to traditional scores, can support individualized triage, optimizing clinical decision-making in UGIB management and holding the potential to reduce the mortality burden. Declarations Ethics approval The study protocol has been approved by the Eskisehir City Hospital Scientific Research Ethics Committee (Health Sciences University Eskisehir H.A.R.C.), (Approval No.: ESH/BAEK 2025/171). Consent for publication Not applicable Competing interests The authors declare that they have no competing interests Funding No funding has been received for the preparation of this manuscript Author Contribution All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by CGY, GY and FAA. The first draft of the manuscript was written by CGY and GY. All authors commented on previous versions of the manuscript and all authors read and approved the final manuscript. Acknowledgements Not applicable Data Availability The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. 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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-8502924","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":583782010,"identity":"5eadf774-5672-4d5f-b422-5c7529048e5a","order_by":0,"name":"Can Gökay Yıldız","email":"","orcid":"","institution":"Tokat State Hospital","correspondingAuthor":false,"prefix":"","firstName":"Can","middleName":"Gökay","lastName":"Yıldız","suffix":""},{"id":583782011,"identity":"5a77ec38-3e12-45c5-bda6-56b82797d870","order_by":1,"name":"Göknur Yıldız","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7UlEQVRIiWNgGAWjYFACNgjFx5DA+BjMYmZuIE4LG0MCszEDgwFQCyPxWtikwVoYCGiRd29Le8y7hyGxjT39WXVBxZ9o/naglh8V23BqMTxz7LgxzzOgFp4HabdnnDHInXGYsYGx58xt3FpmpLdJ8xwAapFIOHabt80gtwGohZmxjSgtiW3FIC3zCWmRl0g7BtWSzMYM0rKBkBYDnmNpknMOMBi38TxjluY5Y5y7EajlID6/yLe3mUm8OcAg28+e/vAzT4Vc7rzzhw8++FGBx5YDYOq/YwOy6AGc6kG2QJXa41M0CkbBKBgFIxwAAMdXVK2I1yl6AAAAAElFTkSuQmCC","orcid":"","institution":"Health Sciences University Eskisehir H.A.R.C.","correspondingAuthor":true,"prefix":"","firstName":"Göknur","middleName":"","lastName":"Yıldız","suffix":""},{"id":583782012,"identity":"66999a0d-8df4-41f6-bdb4-7309538b7ce4","order_by":2,"name":"Fatih Alper Ayyıldız","email":"","orcid":"","institution":"Health Sciences University Eskisehir H.A.R.C.","correspondingAuthor":false,"prefix":"","firstName":"Fatih","middleName":"Alper","lastName":"Ayyıldız","suffix":""}],"badges":[],"createdAt":"2026-01-02 19:08:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8502924/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8502924/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":101788016,"identity":"e7468e72-802e-4890-9717-1837a79c2e0c","added_by":"auto","created_at":"2026-02-03 15:52:26","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":45351,"visible":true,"origin":"","legend":"\u003cp\u003eThe ROCs of GPR, LAR, UAR, AIMS65, GBS and Rockall score for ICU admission\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-8502924/v1/15140cec0f99c2b58a5feefd.png"},{"id":101881203,"identity":"7460db0c-e334-479a-9d04-ba0d978a0f81","added_by":"auto","created_at":"2026-02-04 15:10:39","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":46057,"visible":true,"origin":"","legend":"\u003cp\u003eThe ROCs of GPR, LAR, UAR, AIMS65, GBS and Rockall score for intubation\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-8502924/v1/b0295a2615110335accec0e8.png"},{"id":101788018,"identity":"d5dd5d93-de30-498c-a47f-1f5b91597bf9","added_by":"auto","created_at":"2026-02-03 15:52:26","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":45166,"visible":true,"origin":"","legend":"\u003cp\u003eThe ROCs of GPR, LAR, UAR, AIMS65, GBS and Rockall score for mortality\u003c/p\u003e","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-8502924/v1/25e2ed1b922fd71dae32d186.png"},{"id":101882515,"identity":"2c374141-8641-4173-8110-09773e91933d","added_by":"auto","created_at":"2026-02-04 15:23:08","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1200820,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8502924/v1/1a9dfe64-3633-4874-a588-fe3b6fc49b74.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prognostic Utility of Glucose-to-Potassium, Lactate-to-Albumin, and Uric Acid-to-Albumin Ratios for Adverse Outcomes in Acute Upper Gastrointestinal Bleeding: A Retrospective Cohort Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAcute upper gastrointestinal bleeding (UGIB) is considered a common and potentially life-threatening emergency, with an estimated annual incidence of 50\u0026ndash;150 cases per 100,000 population and an in-hospital mortality rate of approximately 10%; this rate remains unchanged despite advances in endoscopic and pharmacological treatments (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). This condition imposes a significant burden, particularly in emergency departments (EDs), where rapid risk stratification is essential to guide decisions on hospitalization, transfusion, and urgent endoscopy (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Hemodynamic instability at presentation is observed in 20\u0026ndash;30% of cases and increases the risk of multiorgan failure and death (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Therefore, effective prognostic tools that identify high-risk patients for intensive care unit (ICU) admission or early intervention are critically important; they also enable safe triage of low-risk individuals for outpatient management.\u003c/p\u003e \u003cp\u003eVarious validated scoring systems have been developed to predict clinical outcomes in UGIB, including the need for intervention, rebleeding, and mortality. The Glasgow-Blatchford Score (GBS) is widely used for pre-endoscopic risk assessment, emphasizing clinical and laboratory parameters such as blood urea nitrogen and hemoglobin to identify patients requiring hospital admission or endoscopic therapy; however, its performance in predicting mortality is modest (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). The AIMS65 score, derived from ED cohorts, incorporates age, International Normalized Ratio (INR), altered mental status, systolic blood pressure, and comorbidities, demonstrating superior accuracy for in-hospital mortality prediction compared to GBS in some settings; however, its specificity for endoscopic needs is limited (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). The Rockall score, particularly its pre-endoscopic version, integrates endoscopic findings with clinical variables to forecast rebleeding and mortality, outperforming GBS in high-risk variceal bleeds but showing variable discriminatory power in nonvariceal UGIB (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Recent comparative studies highlight the complementary strengths of these tools\u0026mdash;AIMS65 for mortality, GBS for intervention, and Rockall for comprehensive risk\u0026mdash;but underscore the need for integrated biomarkers to enhance overall predictive accuracy, especially in resource-limited ED environments (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBeyond traditional scores, laboratory-derived ratios provide simple and cost-effective prognostic insights by reflecting underlying metabolic, inflammatory, and hypoxic derangements in critically ill patients. The glucose-to-potassium ratio (GPR) has gained attention as a marker of metabolic stress and electrolyte imbalance, correlating with 28-day mortality in sepsis and predicting poor outcomes in traumatic brain injury, where elevated ratios are independent of glucose alone (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Similarly, the lactate-to-albumin ratio (LAR) integrates tissue hypoperfusion (lactate) with nutritional/inflammatory status (albumin), demonstrating strong associations with ICU mortality in sepsis and signaling heightened risk of organ failure in acute-on-chronic liver failure, where ratios\u0026thinsp;\u0026gt;\u0026thinsp;0.5 are indicative (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). The uric acid-to-albumin ratio (UAR), reflective of oxidative stress and hypoalbuminemia, has been linked to short-term mortality in acute kidney injury and atrial fibrillation recurrence, positioning it as a novel indicator of systemic inflammation in acute illnesses (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Despite these promising applications, the utility of GPR, LAR, and UAR in UGIB remains underexplored; to date, no studies have examined their correlations with AIMS65, GBS, and Rockall scores in endoscoped ED patients.\u003c/p\u003e \u003cp\u003eThis study aims to evaluate the prognostic value of admission GPR, LAR, and UAR for mortality, ICU admission, and intubation in patients presenting to the ED with UGIB who undergo endoscopy, and to assess their associations with AIMS65, GBS, and Rockall scores. By addressing this gap, we seek to propose accessible, laboratory-based adjuncts that could refine risk stratification and improve outcomes in this high-risk population.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Setting\u003c/h2\u003e \u003cp\u003eThis study was conducted in the emergency department (ED) of a tertiary care hospital between July 1, 2024, and July 31, 2025. Individuals aged 18 years or older who presented to the emergency department with manifestations consistent with gastrointestinal hemorrhage\u0026mdash;namely, hematemesis, melena, or hematochezia\u0026mdash;underwent endoscopic assessment at our institution and were thereafter admitted to either the general medical ward or the intensive care unit (ICU) for inclusion in this study. Pertinent clinical and demographic parameters were documented at the index presentation. Suspected cases of upper gastrointestinal bleeding (UGIB) were formally verified by a consulting gastroenterologist subsequent to the initial clinical suspicion in the emergency department. Determinations regarding ICU admission were rendered by the gastroenterologist, informed by established selection criteria predicated on the patients' hemodynamic derangements and propensity for recurrent hemorrhage, with subsequent ratification by the ICU specialist. Accordingly, ICU admissions for eligible patients were adjudicated collaboratively by the gastroenterologist and ICU specialist, in strict conformity with institutional guidelines governing intensive care utilization.\u003c/p\u003e \u003cp\u003ePatients with terminal cancer, as well as those with concomitant diagnoses potentially precipitating hospitalization independently of acute gastrointestinal bleeding, were excluded from the study due to their capacity to confound mortality outcomes. Additionally, individuals transferred to external facilities\u0026mdash;owing to the potential disruption of clinical follow-up\u0026mdash;were excluded.\u003c/p\u003e \u003cp\u003eThe study protocol received approval from the Institutional Ethics Committee (Approval No. : ESH/BAEK 2025/171), and informed consent was obtained from all participants in accordance with the Declaration of Helsinki.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eClinical and Laboratory Evaluation\u003c/h3\u003e\n\u003cp\u003eDemographic characteristics of the patients (age and sex), mental status, comorbidities, were systematically documented. Vital signs assessed at the emergency department triage station upon presentation\u0026mdash;namely systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, oxygen saturation and mean blood pressure (MBP)\u0026mdash;were recorded.\u003c/p\u003e \u003cp\u003eVenous blood specimens were procured from all study participants at presentation and subjected to comprehensive biochemical and hematological evaluations via automated instrumentation, specifically the Cell-Dyn Ruby Hematology Analyzer for complete blood count (CBC) determinations and the Architect c8000 platform for biochemical assays.\u003c/p\u003e \u003cp\u003eThe baseline characteristics of the patients included in the study, along with the laboratory data obtained during their emergency department evaluation, were used to calculate the glucose-to-potassium ratio (GPR), lactate-to-albumin ratio (LAR), and uric acid-to-albumin ratio (UAR), AIMS65 score, Glasgow Blatchford score (GBS), and Rockall score.\u003c/p\u003e\n\u003ch3\u003eOutcome Measured\u003c/h3\u003e\n\u003cp\u003eAdverse prognostic endpoints were defined as the requirement for endotracheal intubation, admission to the intensive care unit (ICU), and in-hospital mortality. In the study cohort, the predictive efficacies of the glucose-to-potassium ratio (GPR), lactate-to-albumin ratio (LAR), and uric acid-to-albumin ratio (UAR) in forecasting these adverse outcomes were comparatively evaluated against the AIMS65, GBS, and Rockall scores. ICU admission was operationally defined as either direct transfer from the emergency department or subsequent in-hospital relocation from the ward due to clinical deterioration.\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eContinuous variables with non-normal distributions were presented as median [interquartile range (IQR)]. Categorical variables were expressed as percentages. Data normality was evaluated using the Shapiro-Wilk test, and homogeneity of variances between groups was assessed with Levene's test. Categorical variables were analyzed using the chi-square test. For comparisons between the two groups, non-normally distributed continuous variables were evaluated with the Mann-Whitney U test. Spearman correlation analysis was utilized for evaluating correlations between GPR, LAR, UAR results and other variables.\u003c/p\u003e \u003cp\u003eThe ideal cutoff value, along with sensitivity and specificity for the GPR, LAR and UAR, was determined using receiver operating characteristic (ROC) curve analysis. To evaluate the comparative discriminative capacities, the areas under the receiver operating characteristic (ROC) curves for the GPR, LAR and UAR were juxtaposed via DeLong's test. Furthermore, the optimal threshold values for each metric were derived employing the Youden index. Statistical significance was defined as p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. All analyses were conducted using SPSS version 20.0 (IBM Corp., Armonk, NY, USA).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 472 patients were analyzed, with 294 (62.3%) male and a median age of 71 (60\u0026ndash;81) years. Hypertension (47.5%), diabetes (26.7%), and malignancy (9.7%) were common comorbidities. ICU admission occurred in 368 (78.0%) patients, intubation in 54 (11.4%), and in-hospital mortality in 53 (11.2%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline Characteristics of the Study Population (n\u0026thinsp;=\u0026thinsp;472)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\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 \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNumber (n\u0026thinsp;=\u0026thinsp;472)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71 (60\u0026ndash;81)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex, male\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e294 (62.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e224 (47.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e126 (26.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMalignancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46 (9.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCLF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (5.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCHF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23 (4.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCAD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e186 (39.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCVD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e87 (18.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCRF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36 (7.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGCS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAIMS65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0\u0026ndash;2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGBS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (\u003cspan additionalcitationids=\"CR6 CR7 CR8 CR9 CR10 CR11\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eROCKALL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30.2 (25.0-39.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.051 (0.035\u0026ndash;0.081)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.162 (0.118\u0026ndash;0.220)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICU\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e368 (78.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntubation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54 (11.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMortality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53 (11.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"2\"\u003eHT: Hypertension, DM: Diabetes Mellitus, CLF: Chronic liver failure, CHF: Chronic heart failure, CAD: Coronary artery disease, CVD: Cerebrovascular disease, CRF: Chronic renal failure, GCS: Glasgow coma scale, GBS: Glasgow Blatchford Score, GPR: Glucose-to-potassium ratio, LAR: Lactate-to-albumin ratio, UAR: Uric acid-to-albumin ratio, ICU: Intensive care unit\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eNon-survivors were older [77 years (69.5\u0026ndash;84.5) vs. 70 years, 59\u0026ndash;80; p\u0026thinsp;=\u0026thinsp;0.001] and had lower systolic blood pressure [110 mmHg (80\u0026ndash;138) vs. 121 mmHg (101\u0026ndash;132), p\u0026thinsp;=\u0026thinsp;0.013], higher heart rate [98 bpm (84.5\u0026ndash;106.0) vs. 86 bpm (78\u0026ndash;98), p\u0026thinsp;\u0026lt;\u0026thinsp;0.001], higher lactate [3.1 mmol/L (1.6\u0026ndash;5.5) vs. 1.7 mmol/L (1.2\u0026ndash;2.4), p\u0026thinsp;\u0026lt;\u0026thinsp;0.001], lower hemoglobin [8.6 g/dL (7.0-10.6) vs. 9.9 g/dL (7.6\u0026ndash;12.2), p\u0026thinsp;=\u0026thinsp;0.009], and lower albumin [30.0 g/L (24.5\u0026ndash;32.5) vs. 35.9 g/L (30.6\u0026ndash;41.0), p\u0026thinsp;\u0026lt;\u0026thinsp;0.001]. Risk scores were higher in non-survivors: AIMS65 2 (1.5-3) vs. 1 (0\u0026ndash;2), GBS 11 (\u003cspan additionalcitationids=\"CR9 CR10 CR11 CR12 CR13\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) vs. 8 (\u003cspan additionalcitationids=\"CR6 CR7 CR8 CR9 CR10 CR11\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e), Rockall 6 (\u003cspan additionalcitationids=\"CR6 CR7\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) vs. 5 (\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) (all p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparative Clinical and Laboratory Characteristics Between Survivors and Non-Survivors\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\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=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurvivor (n\u0026thinsp;=\u0026thinsp;419)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-survivor (n\u0026thinsp;=\u0026thinsp;53)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70 (59\u0026ndash;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e77.0 (69.5\u0026ndash;84.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSBP, mmHg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e121 (101\u0026ndash;132)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e110 (80\u0026ndash;138)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDBP, mmHg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70 (61\u0026ndash;78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64 (60\u0026ndash;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.091\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMBP, mmHg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e89.3 (76.3\u0026ndash;95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79.3 (66.7\u0026ndash;96.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.031\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHR, bpm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e86.0 (78\u0026ndash;98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e98.0 (84.5\u0026ndash;106.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSaturation, %\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e98.0 (96\u0026ndash;99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96.0 (93.0-97.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGCS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003epH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.39 (7.36\u0026ndash;7.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.39 (7.32\u0026ndash;7.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.797\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLactate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.7 (1.2\u0026ndash;2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.1 (1.6\u0026ndash;5.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHgb, g/dl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.9 (7.6\u0026ndash;12.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.6 (7.0-10.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHct, %\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30.2 (23.4\u0026ndash;36.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.7 (21.7\u0026ndash;31.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCV, fL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e87.5 (82.6\u0026ndash;91.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86.7 (81.3\u0026ndash;91.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.996\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCHC, g/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32.9 (31.6\u0026ndash;33.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.8 (31.1\u0026ndash;33.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.071\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRBC, 10^6/\u0026micro;L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.5 (2.8\u0026ndash;4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.3 (2.4\u0026ndash;3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlatelet, 10^3/\u0026micro;L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e228 (183\u0026ndash;287)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e252 (216\u0026ndash;279)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.173\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlucose, mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e127 (107\u0026ndash;163)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e146 (118\u0026ndash;182)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.109\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePotassium, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.3 (4.0-4.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.3 (3.8\u0026ndash;4.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.721\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBUN, mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28.7 (19.1\u0026ndash;43.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.5 (22.5\u0026ndash;53.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.133\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatinine, mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.99 (0.79\u0026ndash;1.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.98 (0.66\u0026ndash;1.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.589\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eALT, U/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (\u003cspan additionalcitationids=\"CR11 CR12 CR13 CR14 CR15 CR16 CR17 CR18 CR19\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (\u003cspan additionalcitationids=\"CR10 CR11 CR12 CR13 CR14 CR15 CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23 CR24 CR25 CR26 CR27\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.558\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAST, U/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (\u003cspan additionalcitationids=\"CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23 CR24 CR25\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (15\u0026ndash;52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUric acid, mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.7 (4.3\u0026ndash;7.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.9 (4.4\u0026ndash;7.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.352\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin, g/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35.9 (30.6\u0026ndash;41.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.0 (24.5\u0026ndash;32.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eINR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.1 (1.0-1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2 (1.1\u0026ndash;1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAPTT, s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25.8 (22.8\u0026ndash;29.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.7 (26.6\u0026ndash;40.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30.0 (24.6\u0026ndash;39.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.2 (27.9\u0026ndash;45.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.039\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.049 (0.035\u0026ndash;0.071)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.130 (0.060\u0026ndash;0.169)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.157 (0.117\u0026ndash;0.212)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.203 (0.163\u0026ndash;0.254)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAIMS65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0\u0026ndash;2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1.5-3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGBS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (\u003cspan additionalcitationids=\"CR6 CR7 CR8 CR9 CR10 CR11\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (\u003cspan additionalcitationids=\"CR9 CR10 CR11 CR12 CR13\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRockall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (\u003cspan additionalcitationids=\"CR6 CR7\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eSBP: Systolic blood pressure, DBP: Diastolic blood pressure, MBP: Mean blood pressure, HR: Heart rate, GCS: Glasgow coma scale, Hgb: Hemoglobin, Hct: Hematocrit, MCV: Mean corpuscular volume, MCHC: Mean Corpuscular Hemoglobin Concentration, RBC: Red blood cell, BUN: Blood urea nitrogen, ALT: Alanin aminotransferase, AST: Aspartate transferase, INR: International Normalized Ratio, APTT: Activated partial thromboplastin time, GPR: Glucose-to-potassium ratio, LAR: Lactate-to-albumin ratio, UAR: Uric acid-to-albumin ratio, GBS: Glasgow Blatchford Score\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe ratios were elevated in non-survivors: GPR 33.2 (27.9\u0026ndash;45.0) vs. 30.0 (24.6\u0026ndash;39.3) (p\u0026thinsp;=\u0026thinsp;0.039); LAR 0.130 (0.060\u0026ndash;0.169) vs. 0.049 (0.035\u0026ndash;0.071) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001); UAR 0.203 (0.163\u0026ndash;0.254) vs. 0.157 (0.117\u0026ndash;0.212) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eICU patients were older [74 years (62\u0026ndash;82), vs. 62 years (44\u0026ndash;74); p\u0026thinsp;\u0026lt;\u0026thinsp;0.001], had higher lactate [1.9 mmol/L (1.4\u0026ndash;2.9) vs. 1.4 mmol/L (1.2\u0026ndash;2.1), p\u0026thinsp;=\u0026thinsp;0.001], lower hemoglobin [9.5 g/dL (7.1\u0026ndash;11.1) vs. 11.9 g/dL (9.4\u0026ndash;14.2), p\u0026thinsp;\u0026lt;\u0026thinsp;0.001], and higher risk scores [GPR 31.0 (26.4\u0026ndash;39.5) vs. 26.4 (21.9\u0026ndash;39.8) (p\u0026thinsp;=\u0026thinsp;0.002); LAR 0.056 (0.039\u0026ndash;0.087) vs. 0.041 (0.030\u0026ndash;0.056) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001); UAR 0.168 (0.127\u0026ndash;0.231) vs. 0.141 (0.100-0.192) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparative Characteristics Between Patients Not Requiring and Requiring Intensive Care Unit (ICU) Admission\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\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=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eICU (-) (n\u0026thinsp;=\u0026thinsp;104)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eICU (+) (n\u0026thinsp;=\u0026thinsp;368)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62 (44\u0026ndash;74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74 (62\u0026ndash;82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSBP, mmHg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e126 (113\u0026ndash;132)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e119 (100\u0026ndash;132)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDBP, mmHg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72 (67\u0026ndash;79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70 (60\u0026ndash;76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMBP, mmHg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90.7 (83.3\u0026ndash;96.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86.2 (73.3\u0026ndash;95.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHR, bpm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84 (76\u0026ndash;89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88 (79\u0026ndash;101)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSaturation, %\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e98 (97\u0026ndash;99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97 (96\u0026ndash;98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGCS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003epH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.39 (7.37\u0026ndash;7.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.39 (7.35\u0026ndash;7.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.518\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLactate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.4 (1.2\u0026ndash;2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.9 (1.4\u0026ndash;2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHgb, g/dl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.9 (9.4\u0026ndash;14.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.5 (7.1\u0026ndash;11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHct, %\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36.8 (28.3\u0026ndash;42.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.8 (22.6\u0026ndash;33.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCV, fL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e85.8 (82.0-91.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87.8 (82.7\u0026ndash;92.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCHC, g/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32.9 (31.4\u0026ndash;34.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.8 (31.4\u0026ndash;33.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.544\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRBC, 10^6/\u0026micro;L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.3 (3.3\u0026ndash;4.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.3 (2.6\u0026ndash;3.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlatelet, 10^3/\u0026micro;L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e237 (201\u0026ndash;294)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e229 (180\u0026ndash;287)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.140\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlucose, mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e114 (94\u0026ndash;163)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e132 (112\u0026ndash;168)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePotassium, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.3 (4.1\u0026ndash;4.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.3 (4.0-4.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.944\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBUN, mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.0 (14.0-28.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.5 (20.2\u0026ndash;50.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatinine, mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.88 (0.73\u0026ndash;1.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.01 (0.80\u0026ndash;1.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eALT, U/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16.0 (11.0-24.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.0 (9.0\u0026ndash;20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAST, U/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (\u003cspan additionalcitationids=\"CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23 CR24 CR25\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (\u003cspan additionalcitationids=\"CR15 CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23 CR24 CR25 CR26 CR27 CR28\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.233\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUric acid, mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.5 (4.1\u0026ndash;7.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.8 (4.5\u0026ndash;7.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.229\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin, g/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40.1 (34.8\u0026ndash;44.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.4 (28.7\u0026ndash;39.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eINR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.0 (0.9\u0026ndash;1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.1 (1.0-1.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAPTT, s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26.8 (23.6\u0026ndash;30.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.0 (22.8\u0026ndash;29.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.249\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26.4 (21.9\u0026ndash;39.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.0 (26.4\u0026ndash;39.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.041 (0.030\u0026ndash;0.056)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.056 (0.039\u0026ndash;0.087)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.141 (0.100-0.192)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.168 (0.127\u0026ndash;0.231)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAIMS65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0\u0026ndash;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGBS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.0 (1.0\u0026ndash;8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.0 (6.0-12.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRockall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.0 (1.2-4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.0 (4.0\u0026ndash;7.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eSBP: Systolic blood pressure, DBP: Diastolic blood pressure, MBP: Mean blood pressure, HR: Heart rate, GCS: Glasgow coma scale, Hgb: Hemoglobin, Hct: Hematocrit, MCV: Mean corpuscular volume, MCHC: Mean Corpuscular Hemoglobin Concentration, RBC: Red blood cell, BUN: Blood urea nitrogen, ALT: Alanin aminotransferase, AST: Aspartate transferase, INR: International Normalized Ratio, APTT: Activated partial thromboplastin time, GPR: Glucose-to-potassium ratio, LAR: Lactate-to-albumin ratio, UAR: Uric acid-to-albumin ratio, GBS: Glasgow Blatchford Score\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIntubated patients were older [76.5 years (68.7\u0026ndash;84.2) vs. 70 years (59-80.2); p\u0026thinsp;=\u0026thinsp;0.001], had higher lactate [2.9 mmol/L (1.6\u0026ndash;5.3) vs. 1.7 mmol/L (1.2\u0026ndash;2.4), p\u0026thinsp;\u0026lt;\u0026thinsp;0.001], lower albumin [29.6 g/L (24.7\u0026ndash;32.5) vs. 35.9 g/L (30.7\u0026ndash;41.0), p\u0026thinsp;\u0026lt;\u0026thinsp;0.001], and higher risk scores [GPR 33.2 (27.9\u0026ndash;45.6) vs. 30.0 (24.6\u0026ndash;39.3) (p\u0026thinsp;=\u0026thinsp;0.027); LAR 0.119 (0.060\u0026ndash;0.163) vs. 0.049 (0.034\u0026ndash;0.071) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001); UAR 0.200 (0.163\u0026ndash;0.254) vs. 0.157 (0.117\u0026ndash;0.211) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)] (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparative Clinical Parameters Between Patients Not Requiring and Requiring Intubation\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\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=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntubation (-) (n\u0026thinsp;=\u0026thinsp;418)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIntubation (+) (n\u0026thinsp;=\u0026thinsp;54)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70.0 (59.0-80.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76.5 (68.7\u0026ndash;84.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSBP, mmHg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e121.5 (101.7\u0026ndash;132)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e109.0 (80.0-137.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDBP, mmHg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70 (61\u0026ndash;78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64 (60\u0026ndash;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.069\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMBP, mmHg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e89.5 (76.3\u0026ndash;95.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78.0 (66.7\u0026ndash;96.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHR, bpm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e86 (78\u0026ndash;98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e98.0 (84.7\u0026ndash;106.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSaturation, %\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e98 (96\u0026ndash;99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96 (9\u0026ndash;98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGCS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003epH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.39 (7.36\u0026ndash;7.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.39 (7.33\u0026ndash;7.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.694\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLactate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.7 (1.2\u0026ndash;2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.9 (1.6\u0026ndash;5.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHgb, g/dl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.9 (7.6\u0026ndash;12.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.6 (7.1\u0026ndash;10.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHct, %\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30.2 (23.4\u0026ndash;36.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.6 (21.8\u0026ndash;31.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCV, fL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e87.5 (82.6\u0026ndash;91.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e86.5 (81.6\u0026ndash;91.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.905\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCHC, g/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32.9 (31.6\u0026ndash;33.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.9 (31.1\u0026ndash;33.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.083\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRBC, 10^6/\u0026micro;L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.5 (2.7\u0026ndash;4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.3 (2.4\u0026ndash;3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlatelet, 10^3/\u0026micro;L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e228 (183\u0026ndash;287)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e252.0 (217.5\u0026ndash;282.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.116\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlucose, mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e127 (107\u0026ndash;163)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e147.0 (119.2\u0026ndash;182.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.074\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePotassium, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.3 (4.0-4.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.3 (3.8\u0026ndash;4.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.866\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBUN, mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28.8 (19.0-43.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.5 (22.5\u0026ndash;52.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.156\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatinine, mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.99 (0.79\u0026ndash;1.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.96 (0.66\u0026ndash;1.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.544\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eALT, U/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.0 (10.0-20.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.0 (9.0-26.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.712\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAST, U/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (\u003cspan additionalcitationids=\"CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23 CR24 CR25\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (15\u0026ndash;52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUric acid, mg/dL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.7 (4.3\u0026ndash;7.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.8 (4.4\u0026ndash;7.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.421\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin, g/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35.9 (30.7\u0026ndash;41.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.6 (24.7\u0026ndash;32.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eINR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.1 (1.0-1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.2 (1.1\u0026ndash;1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAPTT, s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25.7 (22.8\u0026ndash;29.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.7 (26.6\u0026ndash;39.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30.0 (24.6\u0026ndash;39.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.2 (27.9\u0026ndash;45.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.049 (0.034\u0026ndash;0.071)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.119 (0.060\u0026ndash;0.163)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.157 (0.117\u0026ndash;0.211)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.200 (0.163\u0026ndash;0.254)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAIMS65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0\u0026ndash;2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGBS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (\u003cspan additionalcitationids=\"CR6 CR7 CR8 CR9 CR10 CR11\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (\u003cspan additionalcitationids=\"CR9 CR10 CR11 CR12 CR13\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRockall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (\u003cspan additionalcitationids=\"CR6 CR7\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eSBP: Systolic blood pressure, DBP: Diastolic blood pressure, MBP: Mean blood pressure, HR: Heart rate, GCS: Glasgow coma scale, Hgb: Hemoglobin, Hct: Hematocrit, MCV: Mean corpuscular volume, MCHC: Mean Corpuscular Hemoglobin Concentration, RBC: Red blood cell, BUN: Blood urea nitrogen, ALT: Alanin aminotransferase, AST: Aspartate transferase, INR: International Normalized Ratio, APTT: Activated partial thromboplastin time, GPR: Glucose-to-potassium ratio, LAR: Lactate-to-albumin ratio, UAR: Uric acid-to-albumin ratio, GBS: Glasgow Blatchford Score\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eCorrelations (Spearman) showed GPR had positive correlation with AIMS65 (r\u0026thinsp;=\u0026thinsp;0.147, p\u0026thinsp;=\u0026thinsp;0.001), GBS (r\u0026thinsp;=\u0026thinsp;0.114, p\u0026thinsp;=\u0026thinsp;0.013), and Rockall (r\u0026thinsp;=\u0026thinsp;0.221, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). LAR and UAR had positive correlations with all scores (all p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and negative correlations with GCS (r=-0.183 to-0.208, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCorrelation Analysis Between GPR, LAR, and UAR Ratios and Risk Scores\u003c/p\u003e \u003c/div\u003e \u003c/caption\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=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGPR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLAR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUAR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAIMS65\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eGBS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eRockall\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eGCS\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \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 \u003ctd align=\"left\" colname=\"c6\"\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\u003eLAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.248\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\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\u003eUAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.080\u003c/p\u003e \u003cp\u003e0.081\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.383\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\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\u003eAIMS65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.147\u003c/p\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.414\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.438\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\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\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\u003eGBS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.114\u003c/p\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.314\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.391\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.486\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\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\u003eRockall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.221\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.424\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.377\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.580\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.516\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \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\u003eGCS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.065\u003c/p\u003e \u003cp\u003e0.157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.208\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.183\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.475\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.235\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.295\u003c/p\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eGPR: Glucose-to-potassium ratio, LAR: Lactate-to-albumin ratio, UAR: Uric acid-to-albumin ratio, GBS: Glasgow Blatchford Score, GCS: Glasgow coma scale.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eROC analyses (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e, Figs.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e) for ICU admission yielded AUCs of 0.60 (GPR), 0.67 (LAR), 0.63 (UAR), 0.71 (AIMS65), 0.76 (GBS), and 0.77 (Rockall) (all p\u0026thinsp;\u0026lt;\u0026thinsp;0.001 except GPR p\u0026thinsp;=\u0026thinsp;0.002). For intubation: 0.59 (GPR, p\u0026thinsp;=\u0026thinsp;0.027), 0.79 (LAR), 0.66 (UAR), 0.79 (AIMS65), 0.66 (GBS), 0.75 (Rockall) (all others p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). For mortality: 0.59 (GPR, p\u0026thinsp;=\u0026thinsp;0.039), 0.79 (LAR), 0.66 (UAR), 0.79 (AIMS65), 0.65 (GBS), 0.75 (Rockall) (all others p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). LAR matched AIMS65 for intubation/mortality (DeLong's p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) and outperformed GPR/UAR (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eROC curve analysis of GPR, LAR, UAR, AIMS65, GBS, and Rockall score for predicting intubation, ICU admission and mortality\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\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=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOutcome\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIndex\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCutoff\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSensitivity (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSpecificity (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAUC (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICU Admission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e78.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.60 (0.53\u0026ndash;0.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e60.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e63.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.67 (0.61\u0026ndash;0.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e59.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.63 (0.57\u0026ndash;0.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAIMS65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e78.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e55.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.71 (0.65\u0026ndash;0.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGBS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e69.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.76 (0.71\u0026ndash;0.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRockall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e65.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e78.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.77 (0.72\u0026ndash;0.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntubation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e58.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.59 (0.51\u0026ndash;0.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e79.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e64.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.79 (0.73\u0026ndash;0.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e60.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.66 (0.59\u0026ndash;0.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAIMS65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e74.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e69.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.79 (0.73\u0026ndash;0.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGBS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e57.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.66 (0.58\u0026ndash;0.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRockall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e66.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.75 (0.69\u0026ndash;0.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMortality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGPR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e58.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.59 (0.50\u0026ndash;0.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.039\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e79.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e64.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.79 (0.73\u0026ndash;0.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUAR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e71.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e54.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.66 (0.59\u0026ndash;0.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAIMS65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e75.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e69.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.79 (0.73\u0026ndash;0.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGBS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e71.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e51.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.65 (0.58\u0026ndash;0.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRockall\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e67.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e66.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.75 (0.69\u0026ndash;0.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eROC: Receiver Operating Characteristic, AUC: Area under the curve, ICU: Intensive care unit, GPR: Glucose-to-potassium ratio, LAR: Lactate-to-albumin ratio, UAR: Uric acid-to-albumin ratio, GBS: Glasgow Blatchford Score\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e This study investigated the prognostic utility of admission glucose-to-potassium ratio (GPR), lactate-to-albumin ratio (LAR), and uric acid-to-albumin ratio (UAR) in predicting adverse outcomes\u0026mdash;intensive care unit (ICU) admission, endotracheal intubation, and in-hospital mortality\u0026mdash;in emergency department (ED) patients with acute upper gastrointestinal bleeding (UGIB) who underwent endoscopy. Our findings demonstrate that these simple laboratory-derived ratios, particularly LAR, offer valuable adjunctive insights into risk stratification, with LAR exhibiting discriminative performance comparable to established scores like AIMS65 for intubation and mortality prediction. While GPR and UAR showed modest associations, LAR's superior area under the receiver operating characteristic curve (AUC) values highlight its potential as a cost-effective biomarker in resource-constrained settings. These results extend prior evidence on metabolic and inflammatory ratios in critical illness, underscoring their relevance in UGIB where rapid, accessible tools are paramount for triaging high-risk patients (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Each ratio reflects distinct facets of UGIB pathophysiology (metabolic stress, hypoperfusion, and oxidative damage), enabling individualized and combined use to enhance clinical decision-making; for instance, elevated LAR may signal urgent endoscopy needs, while GPR could indicate arrhythmia risk from electrolyte imbalances (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe most striking observation was the robust prognostic performance of LAR, which matched AIMS65's AUC for predicting intubation and mortality, outperforming GBS and Rockall in these endpoints while demonstrating moderate discriminatory power for ICU admission. Elevated LAR in non-survivors, intubated patients, and ICU-admitted individuals reflects the interplay of tissue hypoperfusion (elevated lactate) and hypoalbuminemia as a surrogate for inflammation and nutritional depletion\u0026mdash;hallmarks of UGIB severity (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). In our cohort, non-survivors had markedly higher lactate and lower albumin, driving LAR elevations that correlated moderately with risk scores, predicts 28-day mortality independent of SOFA scores and captures endothelial dysfunction and capillary leak in hypovolemic shock (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Similarly, in acute-on-chronic liver failure\u0026mdash;a common UGIB etiology\u0026mdash;LAR thresholds signal multiorgan failure risk, mirroring our findings in variceal and nonvariceal bleeds (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). LAR's success stems from lactate's role as an early hypoxia marker in UGIB; for example, in nonvariceal bleeds, lactate\u0026thinsp;\u0026gt;\u0026thinsp;2.5 mmol/L increases rebleeding risk, while albumin\u0026thinsp;\u0026lt;\u0026thinsp;30 g/L indicates inflammatory response severity (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Unlike AIMS65, which relies on clinical variables like altered mental status, LAR leverages universally available labs, enhancing its feasibility in EDs with limited staffing. However, its lower specificity for mortality and intubation suggests it may over-triage low-risk patients, a limitation shared with AIMS65 and warranting combination models for refined accuracy.\u003c/p\u003e \u003cp\u003eIn contrast, GPR exhibited weaker predictive value, and only borderline significance for intubation and mortality. While non-survivors and intubated patients had modestly higher GPR, its weak correlations with scores and lack of superiority over traditional tools echo prior studies in non-UGIB contexts. GPR's origins in sepsis and traumatic brain injury stem from hyperglycemia-induced potassium shifts exacerbating arrhythmias in stress states, where ratios\u0026thinsp;\u0026gt;\u0026thinsp;30 independently predict 28-day mortality beyond glucose monotherapy (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). Yet, in UGIB, confounding factors like blood urea elevation (from hypovolemia) may dilute GPR's specificity, as seen in our data where glucose levels did not differ significantly between survivors and non-survivors, and potassium imbalances may be modulated by chronic comorbidities (e.g., diabetes) (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Comparative analyses in ED cohorts with mixed shock etiologies report GPR AUCs for ICU needs; these are inferior to lactate alone, suggesting that UGIB's predominant hypovolemic mechanism amplifies electrolyte derangements less potently than septic hypermetabolism (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). GPR's clinical value lies particularly in subgroups with cardiac instability; in our cohort, GPR\u0026thinsp;\u0026gt;\u0026thinsp;32 in hypertensive patients could increase arrhythmia risk and prioritize ECG monitoring (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Nonetheless, GPR's simplicity\u0026mdash;no need for albumin assays\u0026mdash;positions it as a preliminary screen in austere environments, potentially integrated with GBS for intervention prediction, though prospective validation is needed to confirm its adjunctive role (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eUAR, reflective of oxidative stress via hyperuricemia coupled with hypoalbuminemia, displayed intermediate performance, with elevations in adverse groups and moderate score correlations. This builds on evidence from acute kidney injury and atrial fibrillation, where UAR\u0026thinsp;\u0026gt;\u0026thinsp;0.20 forecasts 30-day mortality by indexing purine catabolism as a marker of ischemia-reperfusion injury in bleeding disorders (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). In UGIB, uric acid's rise may stem from gastrointestinal xanthine oxidase activation during hemorrhage-induced hypoxia, while albumin decline signals capillary permeability\u0026mdash;synergistically elevating UAR in 58.7% of ICU cases at our cutoff (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). Our negative GCS correlations further implicate UAR in encephalopathy risk, akin to findings in decompensated cirrhosis where UAR predicts hepatic encephalopathy (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). Compared to LAR, UAR's lower AUCs likely arise from uric acid's bidirectional regulation (e.g., renoprotective at low levels), reducing its sensitivity in early UGIB (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). UAR's strength is evident in patients with renal comorbidity; here, combining UAR with creatinine rise elevates renal failure prediction AUC and guides nephroprotective strategies (e.g., hydration) in UGIB management (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). Still, its accessibility\u0026mdash;using routine biochemistry\u0026mdash;complements Rockall's endoscopic integration, potentially improving post-endoscopy rebleeding forecasts in nonvariceal cases (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eClinically, incorporating LAR into emergency department protocols can help regulate ICU admission rates, reduce unnecessary hospitalizations, and prevent delays in situations requiring intubation. GPR and UAR, on the other hand, provide targeted monitoring in subgroups with high mortality rates.\u003c/p\u003e \u003cp\u003eThis study was conducted at a single center with a cohort of 472 patients, which may limit the generalizability of the findings to diverse populations or healthcare settings. Additionally, the mandatory endoscopy requirement could introduce selection bias, potentially excluding milder cases that did not proceed to invasive evaluation. The lack of outpatient follow-up data represents another constraint, as it might lead to an underestimation of post-discharge rebleeding events. While confounders such as chronic liver failure (observed in 5.7% of participants) were common, our exclusion criteria effectively minimized bias related to terminal illnesses. To address these gaps, prospective multicenter studies are recommended to confirm the proposed cutoffs through serial biomarker assessments and to investigate machine learning approaches for tailoring risk prediction to individual patient profiles.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study has demonstrated the prognostic value of GPR, LAR, and UAR in patients with acute UGIB. In particular, LAR exhibits discriminative performance equivalent to the AIMS65 score in predicting intubation and mortality, emerging as a cost-effective biomarker in resource-limited emergency department settings. While GPR and UAR provide modest associations, LAR's structure, which integrates tissue hypoperfusion and inflammatory response, strengthens risk stratification. These ratios, in addition to traditional scores, can support individualized triage, optimizing clinical decision-making in UGIB management and holding the potential to reduce the mortality burden.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eEthics approval\u003c/h2\u003e \u003cp\u003e The study protocol has been approved by the Eskisehir City Hospital Scientific Research Ethics Committee (Health Sciences University Eskisehir H.A.R.C.), (Approval No.: ESH/BAEK 2025/171).\u003c/p\u003e \u003c/div\u003e\u003ch2\u003eConsent for publication\u003c/h2\u003e \u003cp\u003eNot applicable\u003c/p\u003e\u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e \u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eNo funding has been received for the preparation of this manuscript\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAll authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by CGY, GY and FAA. The first draft of the manuscript was written by CGY and GY. All authors commented on previous versions of the manuscript and all authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e \u003cp\u003eNot applicable\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAppiah JK, Plange-Kaye E, Blewusi GS, Asante R, Asiedu EK. National Trends in Mortality From Upper Gastrointestinal Bleeding in the United States: Disparities and Implications for Emergency Endoscopic Access. 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J Med Assoc Thai. 2020;103(Suppl8):29\u0026ndash;34. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.35755/jmedassocthai.2020.S08.12025\u003c/span\u003e\u003cspan address=\"10.35755/jmedassocthai.2020.S08.12025\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\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":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Upper Gastrointestinal Bleeding, Glucose-to-Potassium Ratio, Lactate-to-Albumin Ratio, Uric Acid-to-Albumin Ratio, Risk Stratification, Mortality Prediction","lastPublishedDoi":"10.21203/rs.3.rs-8502924/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8502924/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eAcute upper gastrointestinal bleeding (UGIB) is a life-threatening emergency with an annual incidence of 50\u0026ndash;150 per 100,000 and ~\u0026thinsp;10% in-hospital mortality. While scores like AIMS65, Glasgow-Blatchford (GBS), and Rockall aid risk stratification, their limitations in resource-limited settings highlight the need for simple, laboratory-derived biomarkers. This study evaluates admission glucose-to-potassium (GPR), lactate-to-albumin (LAR), and uric acid-to-albumin (UAR) ratios for predicting mortality, ICU admission, and intubation in endoscoped emergency department (ED) patients with UGIB.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eIn this retrospective cohort study at a tertiary hospital (July 2024\u0026ndash;July 2025), 472 adults (\u0026ge;\u0026thinsp;18 years) with confirmed UGIB (hematemesis/melena/hematochezia) undergoing endoscopy were included. Baseline demographics, vitals, labs, and scores (AIMS65, GBS, Rockall) were recorded. Ratios were calculated from admission labs. Outcomes were in-hospital mortality, ICU admission, and intubation. Non-normal data were analyzed via Mann-Whitney U and Spearman correlations; predictive performance via ROC curves and DeLong's test (SPSS v20.0; p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eMedian age was 71 years (62.3% male); comorbidities included hypertension (47.5%) and diabetes (26.7%). Mortality occurred in 11.2%, ICU admission in 78.0%, and intubation in 11.4%. Non-survivors had higher LAR (0.130 vs. 0.049, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and UAR (0.203 vs. 0.157, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). LAR correlated positively with scores (r\u0026thinsp;=\u0026thinsp;0.414\u0026ndash;0.424, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). For mortality, LAR AUC was 0.79 (cutoff 0.05; sensitivity 79.2%, specificity 64.2%), matching AIMS65 (0.79) and outperforming GBS (0.65) and Rockall (0.75). Similar for intubation (LAR AUC 0.79). GPR/UAR showed modest AUCs (0.59\u0026ndash;0.66).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eLAR provides AIMS65-equivalent prognostic accuracy for mortality and intubation in UGIB, offering a cost-effective adjunct for ED triage. Integrating these ratios may optimize resource allocation and outcomes in high-risk patients.\u003c/p\u003e","manuscriptTitle":"Prognostic Utility of Glucose-to-Potassium, Lactate-to-Albumin, and Uric Acid-to-Albumin Ratios for Adverse Outcomes in Acute Upper Gastrointestinal Bleeding: A Retrospective Cohort Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-03 15:52:16","doi":"10.21203/rs.3.rs-8502924/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-02-23T03:56:13+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-22T09:16:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"78705420787398924433476355570134745009","date":"2026-02-11T03:29:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"124341638783567263163389236966075643058","date":"2026-02-09T07:55:46+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-30T04:58:56+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-27T08:13:48+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-01-07T18:09:25+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-07T14:58:30+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Gastroenterology","date":"2026-01-07T14:45:58+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"572c67d3-e32e-41ee-8062-5cf7ccb4d9b9","owner":[],"postedDate":"February 3rd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-02-03T15:52:16+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-03 15:52:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8502924","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8502924","identity":"rs-8502924","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}