BACKGROUND AND OBJECTIVES: Acute upper gastrointestinal bleeding (UGIB) is a 
common problem that can cause significant morbidity and mortality. We aimed to 
compare the performance of the ABC score (ABC), the AIMS65 score (AIMS65), the 
Glasgow-Blatchford score (GBS), and the pre-endoscopic Rockall score (pRS) in 
predicting 90-day mortality or rebleeding among patients with acute UGIB.
METHODS: This was a prospective multicenter study conducted at 20 tertiary 
hospitals in China. Data were collected between June 30, 2020 and February 10, 
2021. An area under the receiver operating characteristic curve (AUC) analysis 
was used to compare the performance of the four scores in predicting 90-day 
mortality or rebleeding.
RESULTS: Among the 1072 patients included during the study period, the overall 
90-day mortality rate was 10.91% (117/1072) and the rebleeding rate was 12.03% 
(129/1072). In predicting 90-day mortality, the ABC and pRS scores performed 
better with an AUC of 0.722 (95% CI 0.675-0.768; P<0.001) and 0.711 (95% CI 
0.663-0.757; P<0.001), respectively, compared to the AIMS-65 (AUC, 0.672; 95% 
CI, 0.624-0.721; P<0.001) and GBS (AUC, 0.624; 95% CI, 0.569-0.679; P<0.001) 
scores. In predicting rebleeding in 90 days, the AUC of all scores did not 
exceed 0.70.
CONCLUSION: In patients with acute UGIB, ABC and pRS performed better than 
AIMS-65 and GBS in predicting 90-day mortality. The performance of each score is 
not satisfactory in predicting rebleeding, however. Newer predictive models are 
needed to predict rebleeding after UGIB.