Comparison of Risk Scores in Upper Gastrointestinal Bleeding

Comparison of the Glasgow Blatchford Score, AIMS65, and Pre Endoscopic Rockall Score in Predicting Outcomes of Upper Gastrointestinal Bleeding at a Tertiary Care Centre

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT07819942

Enrollment

100

Registered

2026-09-15

Start date

2026-02-01

Completion date

2026-07-01

Last updated

2026-09-15

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

UGI Bleed

Keywords

Gastrointestinal Hemorrhage, Risk Assessment, Prognosis, Decision Support Techniques

Brief summary

The goal of this prospective observational study is to compare the Glasgow-Blatchford Score (GBS), AIMS65, and pre-endoscopic Rockall Score in predicting outcomes among patients with upper gastrointestinal bleeding (UGIB). The main questions it aims to answer are: Which score best predicts in-hospital mortality and need for clinical intervention? Which score best predicts rebleeding and length of hospital stay? Researchers will compare the predictive performance of the three scoring systems. Participants will have their clinical and laboratory data collected and will be followed during their hospital stay for relevant outcomes.

Detailed description

Upper gastrointestinal bleeding (UGIB) is a common medical emergency associated with significant morbidity and mortality. Early risk stratification is essential to guide timely intervention, prioritize endoscopy, optimize resource allocation, and identify low risk patients suitable for conservative or outpatient management. Several pre-endoscopic scoring systems, including the Glasgow-Blatchford Score (GBS), AIMS65, and the pre endoscopic Rockall Score, are commonly used; however, their their comparative performance varies across populations, and local data from Nepal remain limited. This prospective observational study aims to compare the predictive accuracy of GBS, AIMS65, and pre-endoscopic Rockall Score in patients presenting with upper gastrointestinal bleeding at a tertiary care hospital in Nepal over a six-month study period. The primary outcomes will include in-hospital mortality and need for clinical intervention (blood transfusion, endoscopic therapy, surgery, or ICU admission). Secondary outcomes will include rebleeding and length of hospital stay. Predictive performance will be evaluated using receiver operating characteristic curve analysis. The findings of this study are expected to identify the most appropriate pre-endoscopic risk stratification tool for UGIB in the Nepalese context, thereby supporting early clinical decision-making and improving patient management.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

16 Years to No maximum

Healthy volunteers

Inclusion criteria

* Age ≥16 years. * Presenting with acute UGIB (hematemesis, melena, or hematochezia). * Patients providing informed written consent.

Exclusion criteria

* Patients with lower gastrointestinal bleeding or uncertain source of bleeding. * Patients with prior UGIB within the last 30 days. * Patients refusing consent. * Patients who are lost to follow-up before assessment of primary outcomes.

Design outcomes

Primary

Measure	Time frame	Description
Requirement for Blood Transfusion Within 24 Hours	Within 24 hours of hospital admission	Proportion of participants requiring blood transfusion (packed red blood cells or Whole blood) within 24 hours of presentation.
Rate of Intensive Care Unit (ICU) Admission	through study completion, an average of 7 days	Proportion of participants requiring admission to the ICU due to severe upper gastrointestinal bleeding or hemodynamic instability.

Secondary

Measure	Time frame	Description
In-Hospital Rebleeding Rate	through study completion, an average of 7 days	Proportion of participants experiencing recurrent bleeding (characterized by fresh hematemesis, melena with hemodynamic instability, or persistent drop in hemoglobin (\>2gm/dl) after index hemostasis during the index admission.
Early Mortality (Within 48 Hours)	Within 48 hours of hospital admission.	Proportion of all-cause patient deaths occurring within 48 hours of initial presentation.
Overall In-Hospital Mortality	through study completion, an average of 7 days	Proportion of all-cause patient deaths occurring during the index hospital stay.

Countries

Nepal

Outcome results