ASGE oral abstract
155 Risk Stratification in Acute Upper Gastrointestinal Bleeding: AIMS65 Is Superior to Glasgow-Blatchford and Rockall Scoring Systems in Predicting Inpatient Mortality

https://doi.org/10.1016/j.gie.2014.02.037Get rights and content

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Aims

To validate AIMS65 as a predictor of inpatient mortality in patients presenting with UGIB and to compare AIMS65 with established GBS and pre-endoscopy Rockall scores.

Methods

ICD-10 codes were used to identify patients presenting with UGIB requiring endoscopy to the Austin Hospital, a tertiary referral centre, over a 42-month period from 2010 to 2013. Patients were excluded if data required for calculation of risk scores were incomplete or if medical records revealed an alternative diagnosis. All patients were risk stratified using AIMS65, GBS and Rockall scores. Primary outcome was inpatient mortality. Secondary outcomes were: a composite endpoint of inpatient

Results

424 patients were included in the study. Median age was 71 years (range 15-93) and 66% were male. 293 (69%) patients presented on antiplatelet or anticoagulant therapy (154 (36%) aspirin, 48 (11%) clopidogrel and 90 (21%) warfarin or heparin); 209 (49%) presented on a proton pump inhibitor. Mortality was 4.3% and 17% achieved the composite endpoint. AIMS65 was superior to both GBS (AUROC 0.80 vs. 0.76, p<0.027) and Rockall (0.74, p=0.001) in predicting inpatient mortality and need for ICU

Conclusion

AIMS65 is a simple risk stratification score for UGIB with superior accuracy to GBS and pre-endoscopy Rockall scores in predicting in-hospital mortality and need for ICU. If these results are confirmed in a prospective trial, AIMS65 should become the new standard of care.

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