Application of AIMS65 Score in the Prediction of Clinical Outcomes of Patients with Upper Gastrointestinal Hemorrhage
Arunchai Chang, MD1, Keerati Akarapatima, MD1, Attapon Rattanasupar, MD1, Varayu Prachayakul, MD2
Affiliation : 1 Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand 2 Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : The AIMS65 score has been recognized as an accurate tool in predicting outcomes in patients with upper
gastrointestinal hemorrhage (UGIH).
Objective : To determine whether outcomes for patients presenting with UGIH differ depending on low-risk (AIMS65 <2) and high-
risk (AIMS65 >2) scores.
Materials and Methods : The authors conducted a retrospective comparison of in-hospital mortality, other clinical outcomes, and
resource use between low-risk and high-risk UGIH patients in Hatyai Hospital between 2016 and 2017.
Results : There were 322 patients with UGIH included in the present study, of whom 186 patients (57.8%) were low-risk and 136
patients (42.2%) were high-risk. When compared to low-risk patients, high-risk patients had increased risk of in-hospital mortality
(11.8% vs. 2.7%, p = 0.001; adjusted hazard ratio (HR) 4.04, 95% confidence interval (CI) 1.34 to 12.16), needed blood transfusion
(74.3% vs. 39.8%, p<0.001; adjusted HR 4.23, 95% CI 2.42 to 7.42), endoscopic intervention (44.1% vs. 24.7%, p<0.001; adjusted
HR 2.06, 95% CI 1.19 to 3.57) and overall intervention (46.3% vs. 24.7%, p<0.001; adjusted HR 2.19, 95% CI 1.24 to 3.86).
There was no significant difference in rebleeding between the two groups (3.7% vs. 2.2%, p = 0.501; adjusted HR 1.71, 95% CI 0.43
to 6.87). High-risk patients were associated with longer hospitalization (median (IQR) = 5 (4 to 7) days vs. 4 (3 to 5) days, p<0.001)
and higher hospitalization cost (median (IQR) = 687.4 (450.7 to 1,023.1) vs. 537.1 (388.5 to 819.1) US dollars, p<0.001).
Conclusion : The AIMS65 score is simple and accurate in predicting clinical outcomes. High-risk patients (AIMS65 >2) had increased
risk of in-hospital mortality and needed of blood transfusion, endoscopic intervention, and overall intervention and were associated
with greater hospital stay and cost.
DOI: 10.35755/jmedassocthai.2020.S08.11999
Keywords : AIMS65 score, Upper gastrointestinal hemorrhage, Gastrointestinal bleeding, Mortality, Outcome, Resource
