AIMS65 Outperforms Other Scoring Systems for Non-Variceal Upper Gastrointestinal Bleeding in Octogenarians: A Prospective Study

Abstract

Background: The incidence and adverse clinical outcomes of nonvariceal upper gastrointestinal bleeding (NVUGIB) increase significantly with advanced age. Among those over 80 years of age (octogenarians), this risk becomes markedly pronounced. Our study aimed to assess the predictive ability of four recognized scoring systems for clinical outcomes in octogenarians presenting with NVUGIB. Methods: We compared the Clinical Rock all Score (CRS), Full Rockall Score (FRS), Glasgow Blatchford Score (GBS), and AIMS65 scores for their ability to forecast clinical outcomes. These outcomes encompassed: (1) the requirement for endoscopic intervention, (2) recurrence of bleeding, and (3) 30-day mortality. Results: The study sample comprised 107 octogenarians, including 58 males (54.2%), with a median age of 86 (range 82-89). Ten patients (9.3%) experienced recurrent bleeding, while 19 (17.8%) succumbed within 30 days. The AIMS65 score predicted 30-day mortality with an optimal cutoff value of 2.5, demonstrating 63% sensitivity and 86% specificity. In patients categorized as high-risk by the AIMS65 criteria, a cutoff value of 2 predicted 30-day mortality with 75% sensitivity and 68% specificity. Conclusions: The easily calculable pre-endoscopic AIMS65 score proves beneficial for predicting mortality among octogenarians with NVUGIB, thereby assisting clinical decision-making processes.