Predictive Value of qSOFA Score,Hemoglobin and Fibrinogen for the Mortality Risk in Patients with Acute Upper Gastroin-testinal Bleeding

LIU Libo; SHAO Suhua; WANG Baowei; WU Ming

doi:10.13730/j.issn.2097-2148.2025.11.007

Abstract：Objective To investigate the predictive value of quick sequential organ failure assessment(qSOFA)score,hemoglobin(Hb)and fibrinogen(FIB)on the risk of patient mortality with acute upper gastrointestinal bleeding(AUGIB).Methods A total of 286 patients admitted to the department of emergency medicine of the author's hospital from January 2021 to January 2023 were used as investigators.The clinical data of patients at the time of admission was collected,then the patients were divided into the fatal group(n=28)and the survival group(n=258)according to whether they died or not,the general clinical data of the patients between two groups were compared.Logistic regression was used to analyze the influencing factors of death in AUGIB patients.R4.2.3 software and rms software package were used to construct a nomogram model for predicting the mortality risk of AUGIB patients.The receiver operating character-istic(ROC)curve was drawn to evaluate the discrimination of the nomogram model.Calibration curve and Hosmer-Leme-show goodness-of-fit test were used to evaluate the accuracy of the prediction model.Results Compared with the survival group,the proportion of patients with a history of upper gastrointestinal bleeding and qSOFA score in the death group in-creased(all P＜0.05);and the levels of systolic blood pressure(SBP),diastolic blood pressure(DBP),Hb,platelet(PLT),FIB and albumin(ALB)decreased(all P＜0.05).Logistic regression analysis showed that high qSOFA score(OR:2.909,95％CI:1.647-5.141)was an independent risk factor for death in patients with AUGIB,high Hb(OR:0.967,95％CI:0.948-0.987)and high FIB(OR:0.990,95％CI:0.983-0.996)were independent protective factors for death in AUGIB patients.The three variables were introduced into R4.2.3 software to obtain a nomogram model for predicting AUGIB mortality.The area under the curve(AUC)of the model for predicting mortality risk of AUGIB patients was 0.847(95％CI:0.764-0.930),with a sensitivity of 0.786 and a specificity of 0.826.Calibration curve analysis showed that the calibration curve of the model for predicting the mortality of AUGIB patients was roughly consistent with the actual curve.Hosmer-Leme-show goodness of fit test showed that there was no significant difference between the predicted mortality rate of the model and the actual mortality rate(x2=5.788,P=0.671).Conclusion The mortality risk prediction model constructed by qSOFA score,Hb and FIB has a good predictive effect on the death of AUGIB patients.