DOI: 10.4103/aam.aam_463_26 ISSN: 1596-3519

AIMS65 Score as a Predictor of Inhospital Outcomes in Patients with Chronic Liver Disease Presenting with Upper Gastrointestinal Bleeding

Smriti Bharti, Gagan Gunjan, Pragya Pant, Anand Dev, Bindey Kumar

Abstract

Background:

Upper gastrointestinal bleeding (UGIB) in chronic liver disease (CLD) carries a high risk and requires early stratification. This study evaluated the prognostic value of the AIMS65 score in CLD patients with UGIB.

Methods:

This prospective observational study included 131 adult CLD patients with UGIB admitted over 18 months at Rajendra Institute of Medical Sciences, Ranchi. Patients were grouped as AIMS65 <3 and AIMS65 ≥3. The primary outcome was inhospital mortality; secondary outcomes were intensive care unit (ICU) admission, rebleeding, and length of hospital stay. Mortality prediction by AIMS65 was compared with Child–Pugh and model for end-stage liver disease (MELD) scores.

Results:

The median age was 54 years (interquartile range: 46–63), and 54.9% were male. Variceal bleeding was present in 68.0% of patients. Compared with AIMS65 <3, patients with AIMS65 ≥3 had higher inhospital mortality (31.3% vs. 4.7%), ICU admission (50.7% vs. 12.5%), rebleeding (40.3% vs. 7.8%), and longer hospital stay (13.5 ± 3.8 vs. 7.3 ± 2.1 days) (all P < 0.001). AIMS65 showed the highest discrimination for inhospital mortality (area under the curve: 0.88; 95% confidence interval [CI]: 0.80–0.95), compared with Child–Pugh (0.84; 95% CI: 0.75–0.92) and MELD (0.81; 95% CI: 0.72–0.90).

Conclusions:

Higher AIMS65 scores were associated with adverse inhospital outcomes in CLD patients with UGIB. AIMS65 showed better mortality discrimination than Child–Pugh and MELD in this cohort and may be a useful bedside risk stratification tool.

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