ABC score is an effective predictor of outcomes in peptic ulcer bleeding

Abstract BackgroundRisk stratification is recommended for patients presenting with gastrointestinal bleeding. The ABC score is a new scoring tool with high accuracy for both upper and lower gastrointestinal bleeding. This study aimed to evaluate the effectiveness of the ABC score in predicting the outcomes of patients with peptic ulcer bleeding.MethodsThis single-center retrospective study was conducted between October 2011 and March 2021. We identified 812 patients presenting with symptoms of upper gastrointestinal hemorrhage who were diagnosed with ulcerative lesions on endoscopy. The association between the ABC score’s variables and the patients’ outcome was analyzed using the chi-square test, Fisher’s exact test, and t-test. Additionally, the performance of the score in predicting the patients’ outcome was validated using ROC curve analysis and compared to the performance of other scores.ResultsA total of 772 patients with peptic ulcer bleeding were analyzed. The primary outcome measure (20 patients) was all-cause 30-day mortality. Secondary outcome measures (91 patients) included rebleeding within 30 days and need for radiologic/surgical intervention. Age (p = 0.013), serum albumin (p < 0.001), serum creatinine (p = 0.004), mental status (p < 0.001), and ASA score (p < 0.001) were factors associated with the primary outcome. The ABC score was 7, with a sensitivity of 90.0% and a specificity of 86.0%. It predicted the primary outcome with good accuracy (area under the receiver operating characteristic curve [AUROC] 0.927; 95% confidence interval [CI] 0.899–0.956), surpassing other scores. However, it was less accurate in predicting rebleeding (AUROC 0.630; 95% CI 0.563–0.697) and need for radiologic/surgical intervention (AUROC 0.641; 95% CI 0.550–0.732).ConclusionsThe ABC score is a good predictor of 30-day mortality in patients with peptic ulcer bleeding. However, it may not be suitable for predicting rebleeding or the need for radiologic/surgical interventions.