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KMID : 1038120150480050380
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Clinical Endoscopy
2015 Volume.48 No. 5 p.380 ~ p.384
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Clinical Application of AIMS65 Scores to Predict Outcomes in Patients with Upper Gastrointestinal Hemorrhage
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Thandassery Ragesh Babu
Sharma Manik
John Anil K
Al Ejji Khalid Mohsin
Wani Hamidulla
Sultan Khaleel
Al Mohannadi Muneera
Yakoob Rafie
Derbala Moutaz
Al Dweik Nazeeh
Butt Muhammed Tariq
Al Kaabi Saad Rashid
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Abstract
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Background/Aims: To evaluate the ability of the recently proposed albumin, international normalized ratio (INR), mental status, systolic blood pressure, age >65 years (AIMS65) score to predict mortality in patients with acute upper gastrointestinal bleeding (UGIB).
Methods: AIMS65 scores were calculated in 251 consecutive patients presenting with acute UGIB by allotting 1 point each for albumin level <30 g/L, INR >1.5, alteration in mental status, systolic blood pressure ≤90 mm Hg, and age ≥65 years. Risk stratification was done during the initial 12 hours of hospital admission.
Results: Intensive care unit (ICU) admission, endoscopic therapy, or surgery were required in 51 patients (20.3%), 64 (25.5%), and 12 (4.8%), respectively. The predictive accuracy of AIMS65 scores ≥2 was high for blood transfusion (area under the receiver operator characteristic curve [AUROC], 0.59), ICU admission (AUROC, 0.61), and mortality (AUROC, 0.74). The overall mortality was 10.3% (n=26), and was 3%, 7.8%, 20%, 36%, and 40% for AIMS65 scores of 0, 1, 2, 3, and 4, respectively; these values were significantly higher in those with scores ≥2 (30.9%) than in those with scores <2 (4.5%, p<0.001).
Conclusions: AIMS65 is a simple, accurate, non-endoscopic risk score that can be applied early (within 12 hours of hospital admission) in patients with acute UGIB. AIMS65 scores ≥2 predict high in-hospital mortality.
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KEYWORD
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AIMS65 score, Upper gastrointestinal bleed, Endoscopy, Mortality
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