Clin Endosc.  2015 Sep;48(5):380-384. 10.5946/ce.2015.48.5.380.

Clinical Application of AIMS65 Scores to Predict Outcomes in Patients with Upper Gastrointestinal Hemorrhage

• Thandassery RB
• Sharma M
• John AK
• Al-Ejji KM
• Wani H
• Sultan K
• Al-Mohannadi M
• Yakoob R
• Derbala M
• Al-Dweik N
• Butt MT
• Al-Kaabi S

• KMID: 2148548
• DOI: http://doi.org/10.5946/ce.2015.48.5.380

Abstract

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 < or =90 mm Hg, and age > or =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 > or =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 > or =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 > or =2 predict high in-hospital mortality.

Keyword

AIMS65 score; Upper gastrointestinal bleed; Endoscopy; Mortality

MeSH Terms

Blood Pressure
Blood Transfusion
Endoscopy
Gastrointestinal Hemorrhage*
Hemorrhage
Hospital Mortality
Humans
Intensive Care Units
International Normalized Ratio
Mortality

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