Analysis of factors associated with 1-year rebleeding in patients with acute upper gastrointestinal bleeding and a Glasgow- Blatchford Score ≥ 6 based on serological indicators.

Objective: Analysis of serological indicators for recurrent bleeding within 1 year in patients with upper gastrointestinal bleeding and a Glasgow-Blatchford Score (GBS) ≥ 6, identification of independent risk factors, and development of a risk prediction model for recurrent bleeding within 1 year. Methods: This study enrolled 575 patients with acute upper gastrointestinal bleeding and a GBS score ≥ 6. Feature selection was performed using Lasso regression to identify statistically significant variables. The cohort was then randomly split into a training set ( Results: A new model was developed based on heart rate, blood pressure, hemoglobin, history of peptic ulcer, comorbid liver disease, albumin, platelet count, and CRP. The model achieved an AUC of 0.938 (95% CI: 0.915-0.961) in the training cohort, substantially higher than the AUCs for the GBS (0.590) and AIMS65 (0.562) scores. In the validation cohort, the model maintained an AUC of 0.940, compared to 0.612 for GBS and 0.637 for AIMS65. Superior performance was further evidenced by decision and calibration curve analyses, which indicated advantages in predictive accuracy, calibration, and net clinical benefit over the two conventional scores. Conclusion: The model exhibits robust performance in the prediction of 1-year rebleeding among patients scoring GBS ≥ 6, underscoring its potential clinical applicability.