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Prognostic Value of AIMS65 Score in Cirrhotic Patients with Upper Gastrointestinal Bleeding
Vinaya Gaduputi1, Molham Abdulsamad1, Hassan Tariq1
1Department of Medicine, Bronx Lebanon Hospital Center, 1650 Selwyn Avenue, Suite No. 10C, Bronx, NY 10457, USA.
Insights
The AIMS65 score effectively predicts mortality and hospitalization length in non-cirrhotic patients with upper gastrointestinal bleeding (UGIB). It also correlates with endoscopic findings in this group.
Area of Science:
- Gastroenterology
- Clinical Medicine
- Medical Scoring Systems
Background:
- The Rockall scoring system is widely used for predicting outcomes in upper gastrointestinal bleeding (UGIB).
- The AIMS65 score offers an alternative, relying solely on clinical and laboratory parameters.
- Comparing these scoring systems in diverse patient populations, including those with cirrhosis, is crucial for clinical application.
Purpose of the Study:
- To investigate the correlation between the AIMS65 score and the Endoscopic Rockall score.
- To evaluate the predictive value of AIMS65 for mortality and hospitalization duration in cirrhotic versus non-cirrhotic patients with UGIB.
Main Methods:
- Retrospective analysis of 1255 patients admitted with overt UGIB undergoing esophagogastroduodenoscopy (EGD).
- Calculation of AIMS65 and Rockall scores upon admission.
- Correlation analysis between AIMS65, Endoscopic Rockall scores, and clinical outcomes (mortality, hospitalization length, endoscopic stigmata of bleed).
Main Results:
- A significant correlation was observed between AIMS65 and Total Rockall scores in both cirrhotic and non-cirrhotic patients.
- AIMS65 correlated with Endoscopic Rockall scores in non-cirrhotics but not in cirrhotics.
- AIMS65 scores were significantly higher in patients who died from UGIB, irrespective of cirrhosis status.
- AIMS65 correlated with mortality and hospitalization length in non-cirrhotics, and with mortality in cirrhotics.
Conclusions:
- The AIMS65 score demonstrates a significant correlation with mortality and hospitalization length in non-cirrhotic patients with UGIB.
- AIMS65 effectively parallels endoscopic lesion grading in non-cirrhotic patients.
- In cirrhotic patients, AIMS65 primarily correlates with mortality, showing less association with hospitalization length or endoscopic stigmata of bleed compared to non-cirrhotics.
Abstract:
Introduction. Unlike Rockall scoring system, AIMS65 is based only on clinical and laboratory features. In this study we investigated the correlation between the AIMS65 score and Endoscopic Rockall score, in cirrhotic and noncirrhotic patients. Methods. This is a retrospective study of patients admitted with overt UGIB and undergoing esophagogastroduodenoscopy (EGD). AIMS65 and Rockall scores were calculated at the time of admission. We investigated the correlation between both scores along with stigmata of bleed seen on endoscopy. Results. A total of 1255 patients were studied. 152 patients were cirrhotic while 1103 patients were noncirrhotic. There was significant correlation between AIMS65 and Total Rockall scores in patients of both groups. There was significant correlation between AIMS65 score and Endoscopic Rockall score in noncirrhotics but not cirrhotics. AIMS65 scores in both cirrhotic and noncirrhotic groups were significantly higher in patients who died from UGIB than in patients who did not. Conclusion. We observed statistically significant correlation between AIMS65 score and length of hospitalization and mortality in noncirrhotic patients. We found that AIMS65 score paralleled the endoscopic grading of lesion causing UGIB in noncirrhotics. AIMS65 score correlated only with mortality but not the length of hospitalization or endoscopic stigmata of bleed in cirrhotics.
