AIMS65 Score for Predicting Mortality in Acute Upper Gastrointestinal Bleeding

David J. Bjorkman, MD, MSPH (HSA), SM (Epid.) reviewing Robertson M et al. Gastrointest Endosc 2015 Oct 26.

The AIMS65 performed better than commonly used pre-endoscopy scores and as well as the post-endoscopy Rockall score in predicting in-hospital mortality.

Early risk stratification is the standard of care for acute upper gastrointestinal bleeding. Multiple scoring systems are used to accomplish this — most commonly the pre-endoscopy and post-endoscopy Rockall scores (pre-RS and post-RS) and the Glasgow-Blatchford score (GBS). The most recently proposed score, the AIMS65, is touted by its proponents as simpler and more likely to be used than other scores.

To compare the predictive abilities of these four scoring systems, investigators retrospectively assessed in-hospital mortality (primary endpoint) and subsequent complication or intervention (a composite secondary endpoint) in 424 patients with acute upper gastrointestinal bleeding who underwent endoscopy at a single hospital in Australia. The pre-RS, post-RS, GBS, and AIMS65 scores were calculated for all patients.

The AIMS65 was statistically superior to the GBS and pre-RS in predicting mortality (area under the receiver-operating characteristic curve [AUROC], 0.80 vs. 0.76 and 0.74, respectively) but not the post-RS (0.78). The AIMS65, GBS and post-RS were similarly effective in predicting complication or intervention (AUROC, 0.62, 0.62 and 0.63, respectively) and superior to the pre-RS (0.55).

Citation(s):

Robertson M et al. Risk stratification in acute upper GI bleeding: Comparison of the AIMS65 score to the Glasgow-Blatchford and Rockall scoring systems. Gastrointest Endosc 2015 Oct 26; [e-pub]