Publication: Application of AIMS65 Score in the Prediction of Clinical Outcomes of Patients with Upper Gastrointestinal Hemorrhage
Issued Date
2020-12-01
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01252208
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2-s2.0-85097601579
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol.103, No.12 (2020), S22-S28
Suggested Citation
Arunchai Chang, Keerati Akarapatima, Attapon Rattanasupar, Varayu Prachayakul Application of AIMS65 Score in the Prediction of Clinical Outcomes of Patients with Upper Gastrointestinal Hemorrhage. Journal of the Medical Association of Thailand. Vol.103, No.12 (2020), S22-S28. doi:10.35755/jmedassocthai.2020.S08.11999 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/60531
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Title
Application of AIMS65 Score in the Prediction of Clinical Outcomes of Patients with Upper Gastrointestinal Hemorrhage
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Abstract
© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND| 2020 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.