Upper gastrointestinal system has been used for endoscopic examination and use of pre-endoscopic scoring systems instructions

INTRODUCTION: Upper gastrointestinal tract (GI) bleeding is the most common gastrointestinal disorder leading to hospitalization worldwide. Risk stratification of patients with upper GI bleeding is important for prediction of clinical outcome and indication for endoscopic treatment. Many scoring systems have been developed for risk stratification. In this study, we tried to demonstrate the value of pre-endoscopic scoring systems (mGBS, AIMS65, MAP[ASH]) in predicting the need for and response to endoscopic treatment in patients with upper GI bleeding. MATERIALS AND METHODS: In our study, we prospectively investigated the patients who presented to the emergency department of Sakarya Training and Research Hospital with melena or hematemesis between August and November 2022 and were hospitalized in the Gastroenterology service with the diagnosis of Upper Gastrointestinal System Bleeding. RESULTS: When pre-endoscopic scoring systems of patients with and without endoscopic treatment were compared, no significant difference was observed in terms of AIMS65, mGBS and MAP(ASH) scores. Among the pre-endoscopic scoring systems, mGBS (AUC=0.803) and MAP (ASH) (AUC=0.745) were prominent in predicting the need for transfusion. MAP(ASH) (AUC=0.763, p=0.001) and AIMS65 (AUC=0.700, p<0.001) were found to be the sole determinants of the need for intensive care unit (ICU), but mGBS (AUC=0.592, p=0.339) was not. There was a positive correlation between the duration of hospitalization and MAP(ASH) (p=0.003) and mGBS (p=0.010) scores. At 30-day follow-up, no rebleeding was observed in any patient and no mortality was observed during the same period. CONCLUSIONS: Although the MAP(ASH) scoring system, which is relatively newer than AIMS65 and mGBS scores, was found to be inadequate in predicting the need for endoscopy treatment, it was found to be a strong predictor in all parameters involved in recognizing high-risk patients (blood transfusion and intensive care need, hospitalization days).