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Abstract

Background: Upper gastrointestinal bleeding (UGIB) in cirrhotic patients is a common and serious medical emergency associated with high morbidity and mortality. Early risk stratification is essential to guide clinical management. AIMS65 and Glasgow-Blatchford Score (GBS) are commonly used prognostic tools in UGIB, but their accuracy in cirrhotic patients remains uncertain. Objective: To compare the diagnostic accuracy of AIMS65 and GBS in predicting in-hospital mortality and transfusion requirement among cirrhotic patients presenting with UGIB. Methodology: This cross-sectional study was conducted at the Department of General Medicine, AIMC/Jinnah Hospital, Lahore, over a period of six months. A total of 190 cirrhotic patients aged 18–70 years with UGIB were enrolled through non-probability consecutive sampling. AIMS65 and GBS were calculated at presentation. Clinical outcomes including mortality and need for blood transfusion were recorded. Results: The mean age of participants was 52.4 ± 10.8 years, with 64.2% males. In-hospital mortality was observed in 24 patients (12.6%), while 134 patients (70.5%) required blood transfusions. GBS had higher sensitivity (87.5%) and NPV (97.2%) for mortality prediction compared to AIMS65 (sensitivity 83.3%, NPV 96.5%). Similarly, GBS showed better performance in predicting transfusion requirement (sensitivity 76.1%, PPV 83.3%) than AIMS65 (sensitivity 69.4%, PPV 81.2%). Mean scores of both tools were significantly higher in patients who died or required transfusions (p < 0.05). Conclusion: GBS demonstrated superior diagnostic performance over AIMS65 in predicting both mortality and transfusion needs in cirrhotic patients with UGIB. However, due to the pathophysiological complexity of cirrhosis, both scores should be interpreted cautiously and used alongside clinical judgment. Further studies are needed to validate these findings and explore cirrhosis-specific risk models.