Are Scoring Systems Useful in Predicting Mortality from Upper GI Bleeding in Geriatric Patients?

Introduction and Objective: This study aimed to determine the in-hospital mortality rate after upper gastrointestinal (GI) bleeding in geriatric patients with comorbidities. Additionally, it sought to identify effective cut-off values for predicting high-risk patients using AIMS65 and Rockall scores, and to assess the impact of oral anticoagulant and NSAID use on mortality. : A retrospective cohort study was conducted on 64 patients aged 60 and above with at least one comorbidity who were admitted for upper GI bleeding between January 2023 and June 2024. AIMS65 and Rockall scores were calculated for each patient. The relationship between these scores, medication use, and mortality was analyzed using statistical methods including ROC analysis and Kaplan-Meier survival curves. Findings: The mean age was 77.6 years; all patients had at least one chronic condition. 57.8% were using medications that increase bleeding risk. Overall in-hospital mortality was 18.7%. Use of oral anticoagulants (p=0.275) or NSAIDs (p=0.324) was not significantly associated with mortality. Patients with a Rockall score ≥6 had a mortality rate of 41.6%, with a sensitivity of 90.1% and specificity of 44.2% (AUC=0.920; p<0.001). An AIMS65 score ≥2 predicted a mortality rate of 45.8%, with 91.7% sensitivity (AUC=0.822; p<0.001). Both scores showed a cumulative increase in mortality with rising values (p<0.001). Conclusion: In-hospital mortality following upper GI bleeding is significantly high among elderly patients with comorbidities, largely due to underlying disease decompensation rather than active bleeding. AIMS65 and Rockall scores are effective tools for predicting mortality in this patient group. Taking quicker action using these scoring systems in elderly patients with upper GI bleeding may be beneficial in reducing mortality.