The use of prognostic scales in upper gastrointestinal tract bleeding

In order to select high-risk patients, many prognostic scales have been invented. Among them, the Rockall, Glasgow-Blatchford and AIMS65 scales were considered the most useful.

Patients with non-variceal upper gastrointestinal (GI) tract bleeding, treated between 2017 and 2018, were retrospectively enrolled in the study. Every patient had a Rockall, Glasgow-Blatchford and AIMS65 score calculated retrospectively. Data on hospitalization - blood transfusions, length of hospital stay, rebleeding, intensive care unit (ICU) admission, mortality - were included in the database.

Univariate logistic regression revealed that only the AIMS65 scale was a prognostic factor for in-hospital mortality (OR = 11.028; 95% CI: 2.271-53.563, p = 0.001). The AIMS65 score > 2 was the only factor predicting the need of > 4 blood units transfusion during hospitalization (OR = 3.977; 95% CI: 1.305-12.122, p = 0.015), whereas Glasgow-Blatchford scale > 5 was the only risk factor for the need of fresh frozen plasma transfusion (OR = 3.657; 95% CI: 1.010-13.242, p = 0.048). The area under the curve (AUC) in the ROC analysis revealed that the AIMS65 scale was the most accurate in mortality prediction (AUC = 0.859, p = 0.002), whereas the Rockall and Glasgow-Blatchford scores were not significant (AUC = 0.614, p = 0.093 and AUC = 0.504, p = 0.97, respectively).

Based on our results, we recommend using the AIMS65 scoring system. It is simple and requires few parameters to be counted. Also, it proved to be the most efficient in predicting in-hospital mortality.