Mortality Risk Scoring System in Patients after Bleeding from Cancers in the Upper Gastrointestinal Tract - Article

Q: What is the purpose of the study?

To identify mortality risk factors in patients with upper gastrointestinal cancer bleeding and to develop a predictive model for 30-day mortality.

Q: How were patients selected and what timeframe was analyzed?

Consecutive UGI cancer patients who underwent esophagogastroduodenoscopy for clinically suspected cancer bleeding were retrospectively included from 2009 to 2021.

Q: Which factors make up the new mortality risk scoring model?

The model includes altered mental status, renal failure, rebleeding, age older than 65 years, and low serum albumin (all p<0.05).

Q: How does the new score perform compared with existing scoring systems?

The new model predicted 30-day mortality with an AUC of 0.79, which was significantly higher than the AUCs of the Glasgow-Blatchford score, Rockall, and AIMS65.

Sep 24, 2026

Uploaded by awa

Risk scoring systems for upper gastrointestinal (UGI) bleeding have limited validation for tumor-related bleeding, motivating development of a mortality prediction model. A retrospective single-center cohort of consecutive UGI cancer patients undergoing endoscopic evaluation for suspected bleeding from 2009–2021 was analyzed. Thirty-day mortality and clinical/endoscopic variables were assessed, and a logistic regression model was built and compared with Glasgow-Blatchford, Rockall, and AIMS65 scores. The new model predicted 30-day mortality with superior discrimination and supports improved triage for high-risk patients.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Background/Aims

Methods

Results

Conclusions

Introduction

Materials and Methods

Gut and Liver [https://doi.org/10.5009/gnl230069](https://doi.org/10.5009/gnl230069)[ ](https://doi.org/10.5009/gnl230069)[pISSN 1976-2283 eISSN 2005-1212](pISSN 1976-2283 eISSN 2005-1212) Original Article | Mortality Risk Scoring System in Patients after Bleeding from Cancers in the Upper Gastrointestinal Tract
Hyun Min Kim1 , Donghoon Kang1 , Jun Young Park1 , Yu Kyung Cho1 , Myung-Gyu Choi1,2 , Jae Myung Park1,2 1Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; 2Catholic Photomedicine Research Institute, The Catholic University of Korea, Seoul, Korea | | | | --- | --- | --- | |
See editorial on page 195. | Background/Aims: Risk scoring systems for upper gastrointestinal (UGI) bleeding have not been well validated for tumor bleeding. This study aimed to identify risk factors for mortality inpatients with UGI cancer bleeding and to develop a predictive model. | | | Article Info | Methods: Consecutive patients with UGI cancers who underwent esophagogastroduodenos- | | | Received February 24, 2023 | copy for suspected bleeding were retrospectively included. Patient characteristics, endoscopic | | | Revised June 5, 2023 | findings and 30-day mortality were assessed. A predictive model was made based on risk factors | | | Accepted June 15, 2023 | for mortality using logistic regression, and the area under the curve (AUC) of this model was | | | Published online September 19, 2023 | calculated. It was then compared with other risk scoring systems. | | | Corresponding Author | Results: In a total of 264 patients, 193 had tumor bleeding. Among them, 108 (56 .0%), 76 (39 .4%), and nine (4 .7%) patients received conservative treatment, endoscopic therapy, and | | | Jae Myung Park | non-endoscopic hemostasis, respectively. Rebleeding occurred in 23 (21 .3%), 26 (34 .2%), and | | | ORCID [https://orcid.org/0000-0002-1534-7467](https://orcid.org/0000-0002-1534-7467) | one (11 . 1%) patient(s), respectively. Our new model is composed of altered mental status, renal | | | [E-mail](E-mail parkjerry@catholic.ac.kr)[ parkjerry@catholic.ac.kr](E-mail parkjerry@catholic.ac.kr) | failure, rebleeding, age older than 65 years, and low serum albumin (all p<0 .05) . This model predicted 30-day mortality with an AUC of 0.79 (95% confidence interval, 0.72 to 0.86), which was significantly higher thanAUCs of the Glasgow-Blatchford score, Rockall, and AIMS65 score (AUC=0 .61, 0.64, and 0.69, respectively, all p<0 .05) .
Conclusions: Our new scoring system provides a better prediction of 30-day mortality than existing scoring systems in patients with UGI cancer bleeding. This new scoring system can be used to predict and prepare these patients who are known to have high mortality. (Gut Liver 2024;18:222-230)
Key Words: Mortality; Gastrointestinal hemorrhage; Gastrointestinal neoplasm; Risk assessment; Prognosis | | |
INTRODUCTION | | bleeding does not cause massive bleeding or hemodynamic instability. However, cancer-related bleeding in cancer | | Upper gastrointestinal (UGI) tumor is one of the causes | | patients is a major cause of UGI bleeding and is associated | | of acute UGI bleeding. 1 According to previous studies, | | with high mortality.2 Therefore, it is difficult to predict | | the mortality rate of UGI bleeding is up to 20% in the | | mortality of these patients and make decisions about the | | general population and up to 45% in cancer patients with | | necessity for urgent hemostatic intervention. | | overt UGI bleeding.2 Half of UGI tumor bleeding cases | | Clinical guidelines for UGI bleeding recommend the | | have chronic or latent bleeding rather than acute bleed- | | use of a bleeding risk scoring system to predict patient | | ing.3 The rate of active tumor bleeding that requires urgent | | clinical outcomes.5-8 The Glasgow-Blatchford score (GBS) | | hemostatic interventions such as

FAQs

What is the purpose of the study?

To identify mortality risk factors in patients with upper gastrointestinal cancer bleeding and to develop a predictive model for 30-day mortality.

How were patients selected and what timeframe was analyzed?

Consecutive UGI cancer patients who underwent esophagogastroduodenoscopy for clinically suspected cancer bleeding were retrospectively included from 2009 to 2021.

Which factors make up the new mortality risk scoring model?

The model includes altered mental status, renal failure, rebleeding, age older than 65 years, and low serum albumin (all p<0.05).

How does the new score perform compared with existing scoring systems?

The new model predicted 30-day mortality with an AUC of 0.79, which was significantly higher than the AUCs of the Glasgow-Blatchford score, Rockall, and AIMS65.

Sep 24, 2026

Uploaded by awa