# Comparison of Canada-United Kingdom-Australia (CANUKA) scores of patients with gastrointestinal bleeding presenting to the emergency department with other gastrointestinal bleeding scores

## TL;DR

This study compares different scoring systems for predicting ICU admission and mortality in patients with gastrointestinal bleeding, finding that the CANUKA score performs best for ICU admission.

## Contribution

The study evaluates and compares the performance of the CANUKA score against other established GI bleeding risk scores in predicting ICU admission and mortality.

## Key findings

- The CANUKA score showed the highest discriminative ability for predicting ICU admission (AUC = 0.734).
- AIMS65, CANUKA, and Rockall scores were all statistically significant in predicting mortality.
- CANUKA had the best discriminative ability in predicting ICU admission and second-best for mortality after AIMS65.

## Abstract

Acute gastrointestinal (GI) tract bleeding is a common and potentially life-threatening condition among patients presenting to emergency departments. In this study, we calculated AIMS65, Rockall, Glasgow-Blatchford Score (GBS), and Canada-United Kingdom-Australia (CANUKA) scores in patients with GI bleeding admitted to the emergency department and compared the sensitivity of these scoring systems in predicting the rates of admission to intensive care units and mortality. It is aimed to contribute to clinical practice and help determine an effective risk assessment tool in the management of patients with GI bleeding.

The study was conducted with patients who were diagnosed with GI bleeding. The study was conducted retrospectively between 1 January 2020 and 31 December 2023. The data of the patients were obtained from the hospital automation system. Patients with missing data were excluded from the study. AIMS65, Rockall, GBS, and CANUKA scores of the patients were calculated and recorded separately.

A total of 916 patients were included in our study. The median age was 70 years, and 62.3% of the patients were male. A total of 22.2% of the patients were hospitalized in the intensive care unit (ICU), and the in-hospital mortality rate was 0.9% (n = 8). According to the results of receiver operator characteristic (ROC) analysis of continuous measurements in terms of ICU hospitalization, the ability of the 4 scores to predict ICU hospitalization was statistically significant (p < 0.001). The CANUKA Score had the highest and best discriminative ability to predict ICU admission (area under the ROC curve [AUC] = 0.734). According to the results of ROC analysis of continuous measures in terms of mortality, the ability of AIMS65, CANUKA, and Rockall scores to predict mortality was statistically significant (p-values <0.001, <0.001, and 0.001, respectively).

The CANUKA Score had the best discriminative ability in predicting intensive care unit admission and the best discriminative ability in predicting mortality after the AIMS65 Score.