Comparison of Glasgow Blatchford Score and AIMS65 in Predicting Mortality in Patients with Upper Gastrointestinal Bleeding

Nasser Hajavi, Khatereh Isazadehfar, Mohammad Hosseyn Hosseyni, Afshin Habibzadeh, Elham Yousefi Ardabili

Abstract


Introduction: Upper gastrointestinal bleeding (UGIB) is the most common cause of emergency admission in gastrointestinal disease. UGIB could accompany with adverse events if not treated timely. Different scoring systems have been suggested for diagnosing these patients, In this study we aimed to compare the predictive value of two scoring systems AIMS65 and Glasgow Blatchfors scale (GBS) in patients with UGIB. Methods: In this cross-sectional study, 153 patients (71.9% male with mean age of 56.72±21.64 years) with acute UGIB between April 2017 and September 2018 were included. Demographic findings, past medical history, laboratory findings, AMIS65 and GBS score, as well as, need for urgent endoscopy, transfusion and mortality were recorded. Both methods value in predicting the outcomes were measured using ROC curves. Results and Conclusion: Urgent endoscopy was performed in 44.4%. The most common finding was peptic ulcer with mostly clean base type. Rebleeding occurred in 15%, need for transfusion was in 44.4% and mortality rate was 5.2%. AIMS65 compared to GBS was superior in predicting mortality (AUC of 0.947 vs. 0.80) but was inferior compared to GBS in predicting need for transfusion (0.849 vs. 0.947). None of the systems could predict the need for urgent endoscopy. AIMS65 with cut off 2 and 0 and GBS with cut off of 12 and 8 could predict mortality and need for transfusion. GBS seems a better system in predicting the need for blood transfusion, while AIMS65 is better system for predicting in-hospital mortality in patients with UGIB.

Keywords


Upper Gastrointestinal Bleeding, Aims65, Glasgow Blatchford Scale, Mortality, Transfusion

Full Text:

PDF

References


Cai JX, Saltzman JR. Initial Assessment, Risk Stratification, and Early Management of Acute Nonvariceal Upper Gastrointestinal Hemorrhage. Gastrointest Endosc Clin N Am. 2018;28(3):261-75. doi: 10.1016/j.giec.2018.02.001.

Jafar W, Jafar AJN, Sharma A. Upper gastrointestinal haemorrhage: an update. Frontline Gastroenterol. 2016;7(1):32-40. doi: 10.1136/flgastro-2014-100492.

Choe JW, Kim SY, Hyun JJ, Jung SW, Jung YK, Koo JS, et al. Is the AIMS 65 Score Useful in Prepdicting Clinical Outcomes in Korean Patients with Variceal and Nonvariceal Upper Gastrointestinal Bleeding? Gut Liver. 2017;11(6):813-20. doi: 10.5009/gnl16607.

Beales I. Recent advances in the management of peptic ulcer bleeding. F1000Res. 2017;6:1763. doi: 10.12688/f1000research.11286.1.

Bryant RV, Kuo P, Williamson K, Yam C, Schoeman MN, Holloway RH, et al. Performance of the Glasgow-Blatchford score in predicting clinical outcomes and intervention in hospitalized patients with upper GI bleeding. Gastrointest Endosc. 2013;78(4):576-83. doi: 10.1016/j.gie.2013.05.003.

Chandra S, Hess EP, Agarwal D, Nestler DM, Montori VM, Song LM, et al. External validation of the Glasgow-Blatchford bleeding score and the Rockall score in the US setting. Am J Emerg Med. 2012;30(5):673-9. doi: 10.1016/j.ajem.2011.03.010.

Meltzer AC, Burnett S, Pinchbeck C, Brown AL, Choudhri T, Yadav K, et al. Pre-endoscopic Rockall and Blatchford scores to identify which emergency department patients with suspected gastrointestinal bleed do not endoscopic hemostasis. J Emerg Med. 2013; 44(6):1083-7. doi: 10.1016/j.jemermed.2012.11.021.

Pang SH, Ching JYL, Lau JIW, Sung JJ, Graham DY, Chan FK. Comparing the Blatchford and pre-endoscopic Rockall score in predicting the need for endoscopic therapy in patients with upper GI hemorrhage. Gastrointest Endosc. 2010;71(7):1134-40. doi: 10.1016/j.gie.2010.01.028.

Rickard A, Squire R, Freshwater DA, Smith JE. Validation of the Glasgow Blatchford Score to enable safe discharge of selected patients with upper GI bleeding. J R Nav Med Serv. 2012;98(3):12-4.

Park SW, Song YW, Tak DH, Ahn BM, Kang SH, Moon HS, et al. The AIMS65 Score Is a Useful Predictor of Mortality in Patients with Nonvariceal Upper Gastrointestinal Bleeding: Urgent Endoscopy in Patients with High AIMS65 Scores. Clin Endosc. 2015;48(6):522-7. doi: 10.5946/ce.2015.48.6.522.

Jung SH, Oh JH, Lee HY, Jeong JW, Go SE, You CR, et al. Is the AIMS65 score useful in predicting outcomes in peptic ulcer bleeding? World J Gastroenterol. 2014;20(7):1846-51. doi: 10.3748/wjg.v20.i7.1846.

Martínez-Cara JG, Jiménez-Rosales R, Úbeda-Muñoz M, de Hierro ML, de Teresa J, Redondo-Cerezo E. Comparison of AIMS65, Glasgow–Blatchford score, and Rockall score in a European series of patients with upper gastrointestinal bleeding: performance when predicting in-hospital and delayed mortality. United European Gastroenterol J. 2016;4(3):371-9. doi: 10.1177/2050640615604779.

Park SM, Yeum SC, Kim BW, Kim JS, Kim JH, Sim EH, et al. Comparison of AIMS65 Score and Other Scoring Systems for Predicting Clinical Outcomes in Koreans with Nonvariceal Upper Gastrointestinal Bleeding. Gut Liver. 2016;10(4):526-31. doi: 10.5009/gnl15153.

van Leerdam ME. Epidemiology of acute upper gastrointestinal bleeding. Best Pract Res Clin Gastroenterol. 2008;22(2):209-24. doi: 10.1016/j.bpg.2007.10.011.

Hyett BH, Abougergi MS, Charpentier JP, Kumar NL, Brozovic S, Claggett BL, et al. The AIMS65 score compared with the Glasgow-Blatchford score in predicting outcomes in upper GI bleeding. Gastrointest Endosc. 2013;77(4):551-7. doi: 10.1016/j.gie.2012.11.022.

Gu L, Xu F, Yuan J. Comparison of AIMS65, Glasgow-Blatchford and Rockall scoring approaches in predicting the risk of in-hospital death among emergency hospitalized patients with upper gastrointestinal bleeding: a retrospective observational study in Nanjing, China. BMC Gastroenterol. 2018;18(1):98. doi: 10.1186/s12876-018-0828-5.

Robertson M, Majumdar A, Boyapati R, Chung W, Worland T, Terbah R, et al. Risk stratification in acute upper GI bleeding: comparison of the AIMS65 score with the Glasgow-Blatchford and Rockall scoring systems. Gastrointest Endosc. 2016;83(6):1151-60. doi: 10.1016/j.gie.2015.10.021.

Tang Y, Shen J, Zhang F, Zhou X, Tang Z, You T. Scoring systems used to predict mortality in patients with acute upper gastrointestinal bleeding in the ED. Am J Emerg Med. 2018;36(1):27-32. doi: 10.1016/j.ajem.2017.06.053.

Schacher GM, Lesbros-Pantoflickova D, Ortner MA, Wasserfallen JB, Blum AL, Dorta G. Is early endoscopy in the emergency room beneficial in patients with bleeding peptic ulcer? A "fortuitously controlled" study. Endoscopy. 2005;37(4):324–8. DOI: 10.1055/s-2004-826237

Chen IC, Hung MS, Chiu TF, Chen JC, Hsiao CT. Risk scoring systems to predict need for clinical intervention for patients with nonvariceal upper gastrointestinal tract bleeding. Am J Emerg Med. 2007;25(7):774–9. DOI: 10.1016/j.ajem.2006.12.024




DOI: https://doi.org/10.7575/aiac.abcmed.v.7n.4p.17

Refbacks

  • There are currently no refbacks.


Bookmark and Share


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

2013-2023 (CC-BY) Australian International Academic Centre PTY.LTD.

Advances in Bioscience and Clinical Medicine