In-hospital mortality in patients with lower GI bleeding

In-hospital mortality in patients with lower gastrointestinal bleeding (LGIB) can be significant, depending on various factors. A new tool, the ALIBI score, was developed to predict the risk of death in patients hospitalized with LGIB. This scoring system helps doctors identify high-risk patients and improve their management.

The ALIBI score is based on five key factors that increase the risk of death: older age, higher Charlson co-morbidity index (indicating more severe underlying health conditions), bleeding that starts during hospitalization, hemodynamic instability (e.g., low blood pressure or shock), and elevated serum creatinine (a marker of kidney function). These factors are combined into a 0–13 point scale.

In a study of 1,198 patients, the ALIBI score was tested and then validated on 752 more patients from multiple countries. It showed strong accuracy in predicting mortality, with higher scores indicating greater risk. Patients were categorized into three risk groups: low risk (0–4 points, 1% mortality), intermediate risk (5–9 points, 4.6% mortality), and high risk (10–13 points, 19.1% mortality).

The ALIBI score outperformed previous tools and can guide doctors in prioritizing care, planning interventions, and improving outcomes for patients with LGIB.