The Clinical Significance Of AIMS65 And Glasgow-Blatchford Score System In Acute Upper Gastrointestinal Bleeding Patients

BackgroundAcute upper gastrointestinal bleeding is common clinical serious disease which onset acute and progress fast.According to the severity of the disease which can lead to different consequences,mild patients usually characterized by dizziness,weak,syncope and atypical symptoms,but servious patients can lead to peripheral circulatory failure,shock,and even life-threatening.So how to develop a reasonable treatment plan according to the patient's clinical manifestations and laboratory test results,and to predict the prognosis is the focus of clinical care.ObjectiveTo validate the clinical value of the AIMS65 and Glasgow-Blatchford score system to predict clinical interventions(blood transfusion and intensive care unit admission)and different outcomes(rebleeding and mortality)in acute upper gastrointestinal bleeding patients.MethodsFrom January 2015 to June 2016,the clinical date of 339 acute upper gastrointestinal bleeding patients who met the standards wi th complete information and treated in The First Affiliated Hospital of Zhengzhou University were recorded.Each patient's score of AIMS65 and GBS were calculated.The area under the receiver operating characteristic curve(AUC)was calculated to verify the efficiency of these two score systems in predicting clinical interventions and different outcomes.According to the Youden index,the comparison of two kinds of risk assessment system for clinical intervention and prognosis of different optimal critical value ResultsFirstly,acccording to the increase of the score of AIMS65,the rate of blood transfusion,intensive care unit(ICU)admission,rebleeding,mortality also increase.Secondly,acccording to the increase of the score of GBS,the rate of blood transfusion,intensive care unit(ICU)admission,rebleeding,mortality also increase.Thirdly,the GBS score was superior in predicting inpatient blood transfusion rate(AUC 0.800 vs 0.727,P<0.05);the GBS score was superior in predicting inpatient rebleeding rate(AUC 0.713 vs 0.698,P<0.05);whereas the AIMS65 was superior in predicting mortality rate(AUC 0.859 vs 0.813,P<0.05);the two score systems were similar in predicting ICU admission rate(AUC 0.832 vs 0.833,P>0.05).Fourthly,the cut-off was 2 for the AIMS65 score system for predicting clinical interventions(blood transfusion and ICU admission)and different outcomes(rebleeding and mortality).The cut-off was 11 for the GBS score system for predicting blood transfusion;14 for mortality and ICU admission;13 for rebleeding.ConclusionFirstly,the AIMS65 score system is superior to the GBS in predicting inpatient mortality rate,whereas the GBS is superior for predicting blood transfusion rate and rebleeding rate.Both scores are similar in predicting ICU admission rate.Secondly,the cut-off is 2 for the AIMS65 score system to predict clinical interventions and different outcomes.