Selected participants’ characteristics
Among the total 814 patients with UGIB, 799 participants were eligibly included in this study, with a mean (SD) age of 57.46 (18.04) years and 612 (76.60%) of men. Table 2 displayed the selected characteristics for 799 participants in this study. There were only 15 patients (1.8%) excluded from our analysis due to incomplete information. No death case was observed among those 15 excluded patients. The 15 patients excluded from our analysis (mean ± SD: 73.93 ± 14.84, p < 0.05) were significantly older than those 799 participants included in this study. However there was no statistical difference in gender proportion between the 15 excluded (60% of men) and 799 included patients (76.60% of men, p = 0.13).
Of those 799 UGIB patients, 125 (15.60%) were with variceal bleeding and 674 (84.40%) with nonvariceal bleeding. With respect to the causes of bleeding for these 799 patients, 484 (60.58%) participants were with peptic ulcer bleeding, 65 (8.14%) with cancer bleeding, 40 (5.01%) with Mallory-Weiss syndrome, 9 (1.13%) with erosive esophagitis and 201 (25.16%) with other diseases (e.g., gastro-oesophageal varices, acute gastric mucosal lesions, Dieulafoy’s lesion, or diverticular bleeding).
Associations of RS, GBS and AIMS65 scores with the risk of in-hospital death
The death rate was 3.1% (25/799) among UGIB patients in this study. Table 3 presented the associations of RS, GBS and AIMS65 scores with the risk of in-hospital death among overall 799 participants. After adjustment for potential confounders, AIMS65 (OR = 14.72, 95% CI = 6.48, 33.43) and RS (OR = 1.60, 95% CI = 1.20, 2.13) scores were examined to be positively associated with the risk of death among the overall participants, while marginally significant link (OR = 1.09, 955CI = 0.93, 1.27) was observed between GBS score and death risk.
Table 4 showed the associations of RS, GBS and AIMS65 scores with in-hospital death by type of UGIB. Among participants with NVUGIB, the scenarios of the associations of RS, GBS and AIMS65 scores with in-hospital death were similar to those within overall participants. However, for patients with VUGIB, only AIMS65 was examined to be positively associated with the likelihood of death.
Predictive power of RS, GBS and AIMS65 scoring approaches on the risk of experiencing in-hospital death based on ROC analysis
Figure 1 displayed the AUCs of RS, GBS and AIMS65 scoring systems to predict in-hospital death among overall participants. AIMS65 (AUC = 0.91, 95% CI = 0.84, 0.98) performed the best in predicting in-hospital death, followed by RS (AUC = 0.79, 95% CI = 0.72, 0.86) and GBS (AUC = 0.71, 95% CI = 0.59, 0.83).
Figures 2 and 3 showed the AUCs of RS, GBS and AIMS65 scoring systems to predict in-hospital death among NVUGIB and VUGIB participants, separately. Among the NVUGIB participants, AIMS65 (AUC = 0.89, 95% CI = 0.80, 0.98) performed the best to predict in-hospital death, then RS (AUC = 0.81, 95% CI = 0.73, 0.88) and GBS (AUC = 0.65, 95% CI = 0.50, 0.80), while AIMS65 (AUC = 0.94, 95% CI = 0.89, 1.00) was also the best predictor of in-hospital death, and then GBS (AUC = 0.78, 95% CI = 0.54, 0.93) and RS (AUC = 0.67, 95% CI = 0.50, 0.84) among VUGIB participants.
Optimal cutoff values of RS, GBS and AIMS65 scoring approaches for predicting in-hospital death
In this study, we estimated the optimal cutoff values of RS, GBS and AIMS65 scoring system, separately, for predicting in-hospital death among overall participants based on our ROC analysis (Table 5). The optimal cutoffs were identified to be 3, 12 and 2 for RS, GBS and AIMS65, respectively, and the largest sum of sensitivity (true positive rate) and specificity (true negative rate) produced for each scoring approach was 146% (RS), 140% (GBS) and 172% (AIMS65), separately, based on the corresponding estimated optimal cutoffs in this study.