ORIGINAL RESEARCH article
Front. Med.
Sec. Gastroenterology
This article is part of the Research TopicAdvancing Gastrointestinal Disease Diagnosis with Interpretable AI and Edge Computing for Enhanced Patient CareView all 11 articles
Analysis of Factors Associated with 1-Year Rebleeding in Patients with Acute Upper Gastrointestinal Bleeding and a Glasgow-Blatchford Score ≥ 6 Based on Serological Indicators
Provisionally accepted
- Chaohu Hospital of Anhui Medical University, Hefei, China
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Objective Analysis of serological indicators for recurrent bleeding within one year in patients with upper gastrointestinal bleeding and a Glasgow-Blatchford Score (GBS) ≥6, identification of independent risk factors, and development of a risk prediction model for recurrent bleeding within one year. Methods This study enrolled 575 patients with acute upper gastrointestinal bleeding and a GBS score ≥6. Feature selection was performed using Lasso regression to identify statistically significant variables. The cohort was then randomly split into a training set (n=400) and a validation set (n=175) at a 7:3 ratio. A prediction model was developed through logistic regression analysis on the training set. Additionally, Random Forest analysis was applied, and its outcomes were visualized. The predictive performance of the newly developed model was assessed by means of a receiver operating characteristic curve, a line graph, and calibration and decision curves. Furthermore, the model was compared against the AIMS65 and GBS scoring systems to evaluate its comparative predictive value. Results A new model was developed based on heart rate, blood pressure, hemoglobin, history of peptic ulcer, comorbid liver disease, albumin, platelet count, and CRP. The model achieved an AUC of 0.938 (95% CI: 0.915–0.961) in the training cohort, substantially higher than the AUCs for the GBS (0.590) and AIMS65 (0.562) scores. In the validation cohort, the model maintained an AUC of 0.940, compared to 0.612 for GBS and 0.637 for AIMS65. Superior performance was further evidenced by decision and calibration curve analyses, which indicated advantages in predictive accuracy, calibration, and net clinical benefit over the two conventional scores. . Conclusion The model exhibits robust performance in the prediction of one-year rebleeding among patients scoring GBS ≥6, underscoring its potential clinical applicability.
Keywords: 1-Year Rebleeding, Acute High-Risk upper gastrointestinal bleeding, Acute upper gastrointestinal bleeding, predictive model, GBS
Received: 18 Jul 2025; Accepted: 03 Dec 2025.
Copyright: © 2025 Zhang, Lan and Dou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zheng Li Dou
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