Outcome-Specific Performance of HALP, AIMS65, Glasgow-Blatchford, and Rockall Scores in Emergency Department Patients with Acute Upper Gastrointestinal Bleeding: A Retrospective Cohort Study

Background/Objectives: The Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score integrates hematologic, nutritional, immune, and platelet parameters, but its prognostic value in acute upper gastrointestinal bleeding (UGIB) remains uncertain. We compared the performance of HALP with AIMS65, Glasgow-Blatchford Score (GBS), and Rockall scores.

Methods

We retrospectively studied consecutive adults with endoscopy-confirmed UGIB presenting to the emergency department from January 2021 through December 2024. Outcomes were in-hospital mortality, packed red blood cell (PRBC) transfusion within 24 h, and composite severe UGIB, defined as ≥2 PRBC units transfused within 24 h or UGIB-related intensive care unit admission. Discrimination was assessed using receiver operating characteristic curves and areas under the curve (AUCs); pairwise comparisons used the correlated-sample DeLong test. Firth-penalized logistic regression assessed the adjusted association between HALP and in-hospital mortality.