Significance Of AIMS65 Risks Coring System In Evaluating Prognosis Of Acute Upper Gastrointestinal Bleeding

Aims:To evaluate the clinical value of AIMS65 risk scoring by comparing the performance of AIMS65 score(AIMS65)、Glasgow-Blatchford score(GBS)and Rockall score(RS)forprognosis predictionin upper gastrointestinal bleeding patients.Methods:A retrospective observational study was performed in all patients with acute upper gastrointestinal bleeding(AUGIB)who attended the Nanjing First Hospital from January 2014 to December 2015.Calculated the AIMS65 as well as GBS and RS for each patient,and comparisons of these three risk scores in predicting prognosis(mortality,rebleedingand need for intervention(blood transfusion,endoscopic treatment,surgical treatment))were made by calculation of the areas under the receiver-operator characteristic curves(AUC).Then,devided all the patients into two subgroups:non-variceal upper gastrointestinal bleeding group and variceal upper gastrointestinal bleeding group,and compared the AUC of AIMS65,GBS andRS respectively.Results:A total of 799 patients were enrolled in our study,including 125 variceal bleeding patients.In predicting mortality,the AIMS65 was the best predictor with an AUC of 0.91 compared with the RS(AUC=0.79),and the GBS(AUC=0.71);For predictingrebleeding,AUC was obtained for RS(0.64),GBS(0.73),AIMS65(0.70),respectively,and there were no significantly differences between these scores;In predicting need for intervention,AIMS65was similar to GBS(AUC 0.71 vs.0.76)and RS(AUC 0.71 vs.0.68).Subgroup analysis indicated that AIMS65 was superior or similar to RS and GBS in the prediction of mortality,rebleeding and need for intervention in non-variceal group;In variceal group,AIMS65 was superior to RS and GBS in the prediction of mortality,and AIMS65 as well as RS and GBS were incapable at assessing rebleeding and intervention in patients with variceal upper gastrointestinal bleeding.Conclusions:AIMS65 as well as GBS and RS are all suitable for AUGIB patients.AIMS65 was the best predictor for mortality,and AIMS65 was equal to RS and GBS in predicting rebleeding and need for intervention.AIMS65,GBS and RS were not precise scores for evaluating prognosis in variceal bleeds.