Application of AIMS65 Score in the Prediction of Clinical Outcomes of Patients with Upper Gastrointestinal Hemorrhage

© 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...

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Main Authors: Arunchai Chang, Keerati Akarapatima, Attapon Rattanasupar, Varayu Prachayakul
Other Authors: Hatyai Hospital
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Published: 2020
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/60531
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spelling th-mahidol.605312020-12-28T13:03:12Z Application of AIMS65 Score in the Prediction of Clinical Outcomes of Patients with Upper Gastrointestinal Hemorrhage Arunchai Chang Keerati Akarapatima Attapon Rattanasupar Varayu Prachayakul Hatyai Hospital Faculty of Medicine, Siriraj Hospital, Mahidol University Medicine © 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. 2020-12-28T06:03:12Z 2020-12-28T06:03:12Z 2020-12-01 Article Journal of the Medical Association of Thailand. Vol.103, No.12 (2020), S22-S28 10.35755/jmedassocthai.2020.S08.11999 01252208 2-s2.0-85097601579 https://repository.li.mahidol.ac.th/handle/123456789/60531 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85097601579&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Arunchai Chang
Keerati Akarapatima
Attapon Rattanasupar
Varayu Prachayakul
Application of AIMS65 Score in the Prediction of Clinical Outcomes of Patients with Upper Gastrointestinal Hemorrhage
description © 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.
author2 Hatyai Hospital
author_facet Hatyai Hospital
Arunchai Chang
Keerati Akarapatima
Attapon Rattanasupar
Varayu Prachayakul
format Article
author Arunchai Chang
Keerati Akarapatima
Attapon Rattanasupar
Varayu Prachayakul
author_sort Arunchai Chang
title Application of AIMS65 Score in the Prediction of Clinical Outcomes of Patients with Upper Gastrointestinal Hemorrhage
title_short Application of AIMS65 Score in the Prediction of Clinical Outcomes of Patients with Upper Gastrointestinal Hemorrhage
title_full Application of AIMS65 Score in the Prediction of Clinical Outcomes of Patients with Upper Gastrointestinal Hemorrhage
title_fullStr Application of AIMS65 Score in the Prediction of Clinical Outcomes of Patients with Upper Gastrointestinal Hemorrhage
title_full_unstemmed Application of AIMS65 Score in the Prediction of Clinical Outcomes of Patients with Upper Gastrointestinal Hemorrhage
title_sort application of aims65 score in the prediction of clinical outcomes of patients with upper gastrointestinal hemorrhage
publishDate 2020
url https://repository.li.mahidol.ac.th/handle/123456789/60531
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