Introduction International guidelines recommend the use of a risk stratification score for patients presenting with acute upper gastrointestinal bleeding.1 The Glasgow Blatchford (GB) score is a commonly used scoring system, which was developed as an aid to predict the need for interventions such as endoscopy, blood transfusion or surgery.2 The newer AIMS65 score has recently come into prominence, designed as a simpler score to predict inpatient mortality, length of stay and cost.3 We therefore aim to compare both scoring systems in predicting 5 different outcomes: time to endoscopy, inpatient mortality, intensive care admission, length of stay and number of red cell units transfused.
Method The study took place at the Whittington Hospital, a district general hospital in London, UK, over a 6 month period. Patients were screened for using medical admission lists, with information gathered from electronic and paper records. Patients’ GB and AIMS65 scores were retrospectively calculated from the clinical information available. Depending on the variable, Spearman’s Rank Correlation Coefficient or Receiver Operating Characteristic curves were used to assess the predictive characteristic of each scoring system.
Results 81 patients presented with acute gastrointestinal bleeding. They had a median GB score of 8 and AIMS65 score of 1. A higher GB score equated to a reduced time to endoscopy (ρ=−0.413, p=0.002), but no statistically significant trend was observed for the AIMS65 score. Both scoring systems were predictive for both length of stay and number of red cell units transfused, although AIMS65 score was superior in predicting length of stay (AIMS65 ρ=0.478, p=<0.001 versus GB ρ=0.428, p=<0.001), whereas GB score was superior in predicting number of red cell units transfused (GB ρ=0.615, p=<0.001 versus AIMS65 ρ=0.357, p=0.001). There was no statistically significant difference in predicting inpatient mortality or intensive care admission between the GB and AIMS65 scores.
Conclusion AIMS65 score was superior to the GB score in predicting length of stay, consistent with published findings.4 Similarly, GB score was superior to AIMS65 score in predicting the number of red cell units, consistent with a number of studies.5-7 However for other outcomes the results are mixed 4-7, and more work is needed in establishing the clinical utility of these scoring systems.
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Disclosure of Interest None Declared
- AIMS65 Score
- Glasgow Blatchford Score
- Upper Gastrointestinal Bleeding
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