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Article Type

Original Study

Abstract

Objective This work is a prospective study to emphasize the prognostic value of AIMS65 score in chronic liver disease patients presenting with upper gastrointestinal bleeding (UGIB). Background To optimize the management of UGIB, multiple clinical prediction models have been proposed as a tool to identify patients at risk for poor outcome. Patients and methods This prospective study involved 90 adult patients with chronic liver disease presenting with UGIB, selected from patients admitted in Tropical Medicine Department, Faculty of Medicine, Menoufiya University, Shebeen El-Kom, Menoufiya Governorate, Egypt, during the period from November 2015 to July 2016. Eighty-four of them were male and six were female; their ages ranged from 35 to 79 years. We excluded patients who had melena due to causes other than upper gastrointestinal pathology. AIMS65 score, Glasgow–Blatchford score, Rockall score, Modified Rockall score, Child–Pugh score, and Model for End-Stage Liver Disease score were calculated for each patient. Results The current study showed the following: ICU admission was accurately predicted by AIMS65 score [area under curve (AUC) was 0.946;P = 0.0001]. In this study, an AIMS65 score less than 2 excluded ICU admission. Rebleeding was accurately predicted by AIMS65 score (AUC was 0.844;P = 0.0001). In the current study, an AIMS65 score less than 1 excluded rebleeding. In-hospital mortality was accurately predicted by AIMS65 score (AUC was 0.973;P = 0.0001). AIMS65 score was superior to other scores in predicting mortality. In this study, an AIMS65 score less than 3 excluded in-hospital mortality. Conclusion AIMS65 is accurate, nonendoscopic score for the prediction of ICU admission, rebleeding, in-patient mortality, and cost of hospital stay. Its easy clinical application makes the AIMS65 a good option for some of the clinical outcomes to be predicted in clinical practice.

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