A STUDY ON ACUTE UPPER GI BLEED WITH SPECIAL REFERENCE TO AIMS65 SCORE IN PREDICTING SHORT TERM OUTCOME.

Abstract

Background: Early risk stratication using validated prognostic scales helps in early decision making and triage in clinical practice. Objectives: To evaluate ability of the AIMS65 score to predict mortality, length of hospital stay, requirement of blood transfusions and re-bleeding. Methods: Patients with Upper GI Bleed age ≥ 13 years were taken up for the study. AIMS65 scores were calculated in 250 patients presenting with acute Upper GI bleed by allotting 1 point each for albumin level <3mg/dl, INR>1.5, altered mental status (GCS<14), systolic blood pressure ≤ 90mmHg, and age ≥ 65 years. Patients were categorized into low risk group (score of < 2) and high risk group (score of ≥ 2) based on the score. Results: The predictive accuracy of AIMS65 scores ≥ 2 was high for in-patient mortality, length of hospital stay, requirements of blood transfusions and re-bleeding. Of the total 250 patients, 75.2% had score < 2 and 24.8% had score ≥ 2. 7. 20% patients had re-bleed during the course of hospitalization. 8.4% expired during hospital stay. Re-bleeding, in-patient mortality, requirement of blood transfusion and length of hospital stay increased with increasing AIMS65 score. Conclusions: AIMS65 score is a simple, accurate, non-endoscopic risk scoring system. It helps in stratifying acute UGI bleed patients into different risk groups at the initial stage. AIMS65 scores ≥ 2 predicts in-patients mortality, length of hospital stay, requirements of blood transfusions and re-bleeding.