Comparing AIMS65 Score With MEWS, qSOFA Score, Glasgow-Blatchford Score, and Rockall Score for Predicting Clinical Outcomes in Cirrhotic Patients With Upper Gastrointestinal Bleeding

• Published in: Journal of Acute Medicine 2018-12, Vol.8 (4), p.154-167
• Main Authors: Lai, Yi-Chen, Hung, Ming-Szu, Chen, Yu-Han, Chen, Yi-Chuan
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2211-5587; 2211-5595
• DOI: 10.6705/j.jacme.201812_8(4).0003

Background: The aim of our study was to compare the Age 65; International normalized ratio; Mental status; Shock (AIMS65) score with the Modified Early Warning Score (MEWS), quick Sepsis Related Organ Failure Assessment (qSOFA) score, Glasgow-Blatchford score (GBS), and the complete Rockall score (CRS) in predicting clinical outcomes in cirrhotic patients with upper gastrointestinal bleeding (UGIB). Methods: A total of 442 consecutive cirrhotic patients admitted with UGIB during a 17-month period were retrospectively investigated. The primary outcome was in-hospital mortality. The secondary outcomes were rebleeding, intensive care unit (ICU) admission and development of infection. The area under receiver operating characteristic curve (AUC) for each system was analyzed. Results: For prediction of mortality, the AUC of the AIMS65 score was greater than that of other scoring systems without statistical significance. For the prediction of rebleeding, the AIMS65 score was superior to qSOFA (0.65 vs. 0.56, p = 0.020). For the prediction of ICU admission, the AIMS65 score was superior to the GBS and CRS (0.77 vs. 0.63, p = 0.005 and 0.77 vs. 0.63, p = 0.007, respectively). For the prediction of the development of infection, the AIMS65 score was superior to CRS (0.73 vs. 0.60, p = 0.010). Conclusions: In predicting in-hospital mortality among cirrhotic patients with UGIB, the AIMS65 score showed a trend of better performance than the MEWS, qSOFA score, GBS, and CRS. The AUCs of the AIMS65 score were greater than other four systems in predicting rebleeding, ICU admission and the development of infection.