AIMS65评分预测急性上消化道出血预后的临床应用

K. Maharjan, R. Mandal, Sanjay Shrestha
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摘要

背景:急性上消化道出血(AUGIB)是一种潜在的危及生命的疾病,需要在急诊科快速评估。目前可用的评分是复杂的,并没有广泛应用于临床实践。AIMS65评分是一种简单的评分方法,可用于对AUGIB患者进行风险分层。方法:这是一项描述性横断面研究,于2018年8月至2019年1月在Bir医院单一三级中心NAMS对AUGIB患者进行研究。对急性UGIB患者进行AIMS65评分,白蛋白水平< 3g/dl, INR > 1.5,精神状态改变,收缩压≤90 mm Hg,年龄≥65岁,各1分。在入院的最初12小时内进行风险分层。结果:共纳入84例患者,其中男性68例,女性16例,年龄27 ~ 80岁。住院22例,内镜治疗44例,输血49例。AIMS65评分≥2的患者住院死亡率、输血需要量、内镜治疗或ICU入院率均较高,呈统计学显著正相关(p=0.000)。结论:AIMS65评分是一种简单的非内镜风险评分方法,可用于急性上消化道出血患者的风险分层,预测住院死亡率、是否需要输血、内镜治疗或是否入住ICU。
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Clinical application of AIMS65 score to predict outcome in patients with acute upper gastrointestinal bleeding
BACKGROUND: Acute upper gastrointestinal bleeding (AUGIB) is a potentially life-threatening condition that requires rapid assessment in the emergency department. The current available scores are complex and have not been widely used in clinical practice. AIMS65 score is a simple score that can be used to risk stratify patients with AUGIB. METHODS: This was a descriptive cross-sectional study done at a single tertiary centre, NAMS, Bir Hospital among the patients presenting with AUGIB from August 2018 to January 2019. AIMS65 scores were calculated in patients presenting with acute UGIB by allotting 1 point each for albumin level < 3g/dl, INR > 1.5, alteration in mental status, systolic blood pressure ≤90 mm Hg, and age ≥65 years. Risk stratification was done during the initial 12 hours of hospital admission. RESULTS: A total of 84 patients consisting of 68 males and 16 females were enrolled in our study, with age ranging from 27 to 80 years. ICU admission, endoscopic therapy and blood transfusion were required in 22,44 and 49 patients respectively. In-patient mortality, the need for blood transfusion, endoscopic therapy or ICU admission were higher in those with AIMS65 score ≥ 2 showing statistically significant positive association (p=0.000). CONCLUSION: AIMS65 score is a simple non-endoscopic risk score that can be applied in patients of acute upper gastrointestinal bleeding to risk stratify and to predict in-patient mortality, the need for blood transfusion, endoscopic therapy or ICU admission.  
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