Prognostic scores for risk stratification in patients with acute upper gastrointestinal bleeding

Introduction Acute bleeding from the gastrointestinal (GI) tract is a potentially life-threatening emergency in medical practice, which remains a common reason for admission to a medical facility. The developed prognostic scoring systems assist in risk stratification by differentiating patients with low risk from those with high risk of adverse outcomes. Patients with very low risk can be safely discharged and followed up on an outpatient basis, while hospital treatment is recommended for high-risk cases. Materials and Methods This article is based on a comprehensive review of contemporary full-text articles in English. The information from them, after detailed examination, was analyzed and systematized in order to obtain a complete full-text publication on the general features of prognostic scores for risk stratification in patients with acute upper GI bleeding. Results and Discussion Prognostic scores for acute upper GI bleeding are broadly divided into two main categories depending on the timing of emergency endoscopy: pre-endoscopic and post-endoscopic. The first group includes tools that do not require endoscopic visualization and can be calculated upon admission of the patient, which makes them particularly valuable for early risk stratification. These include the Glasgow-Blatchford Score (GBS), AIMS65, the pre-endoscopic Rockall (pRS), as well as newer scales such as ABC, Canada–United Kingdom–Adelaide (CANUKA), and MAP(ASH). Post-endoscopic systems, e.g., the full Rockall score, Progretto Nazional Emoragia Digestiva (PNED), and Cedars Sinai Medical Centre Predictive Index (CSMCPI), include the endoscopic findings from the emergency gastroscopy and contribute to a more accurate prognosis after the procedure. Conclusion Among the available scales, the GBS demonstrates the highest reliability in identifying low-risk patients who can be safely monitored on an outpatient basis. However, there is currently no scale that can accurately predict the need for endoscopic hemostasis, which necessitates further research and validation of new prognostic models.