Prognostic Value of AIMS65 Score in Cirrhotic Patients with Upper Gastrointestinal Bleeding.

Vinaya Gaduputi,Ahmed Rafeeq,Naeem Abbas,Molham Abdulsamad,Sridhar Chilimuri,Kavitha Kumbum,Hassan Tariq

doi:10.1155/2014/787256

Vinaya Gaduputi, Ahmed Rafeeq + Show 5 more

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https://doi.org/10.1155/2014/787256

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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.

Highlights

Unlike Rockall scoring system, AIMS65 is based only on clinical and laboratory features
We looked at the correlation of AIMS65 score with Total Rockall score and Endoscopic Rockall score separately within each ethnicity (Figure 1)
We wanted to examine the prognostic value of AIMS65 score in patients with cirrhosis presenting with upper gastrointestinal bleeding (UGIB)

Summary

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. 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. We observed statistically significant correlation between AIMS65 score and length of hospitalization and mortality in noncirrhotic patients. AIMS65 score correlated only with mortality but not the length of hospitalization or endoscopic stigmata of bleed in cirrhotics. There have been multiple scores that have been put forth to prognosticate the risk of rebleeding and inpatient mortality rate These scores could be broadly divided into two categories: scores involving weighted endoscopic findings along with clinical and laboratory features (Rockall scores) and scores without the endoscopic criteria (AIMS65 and Blatchford scores). Katschinski et al [1] proposed using Forrest classification, which predicts risk of rebleeding based on endoscopic stigmata, that actively spurting vessels have the highest chance of rebleed whereas clean based ulcer has the lowest

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Conclusion