Predicting 7-Day Re-Bleeding after Peptic Ulcer Hemostasis: Retrospective Analysis of Forrest, Complete Rockall, and Glasgow-Blatchford Scores and Independent Risk Factors

Objective To identify independent risk factors for early ([≤]7-day) re-bleeding after peptic ulcer bleeding (PUB) and to compare the predictive performance of Forrest classification, Complete Rockall Score (CRS), and Glasgow-Blatchford Score (GBS). Methods We retrospectively analyzed adults with endoscopy-confirmed peptic ulcer bleeding from 2015-2020. Early re-bleeding was defined as [≤]7 days after index hemostasis. We applied univariable and multivariable logistic regression and assessed discrimination with ROC curves (AUC). Results Independent risk factors for early re-bleeding included: heart rate (OR 1.054), hemoglobin (OR 1.878), erythrocyte distribution width (OR 1.171), degree of ulcer erosion (OR 1.191), and blood transfusion intervention (OR 12.296). Forrest showed the best discrimination (AUC 0.775; sensitivity 96.2%; specificity 58.8%), followed by GBS (AUC 0.670) and CRS (AUC 0.507) Conclusions Heart rate, hemoglobin, erythrocyte distribution width, ulcer erosion, and blood transfusion are significant risk factors for early re-bleeding in PUB. Forrest grading is the most effective predictor, while GBS can stratify risk and may benefit from modifications. CRS showed limited predictive utility. Limitations single-center, retrospective design; possible residual confounding; no external validation. Clinical implications Forrest can guide intensified monitoring/hemostasis; GBS supports pre-endoscopy triage; CRS adds limited value.