The use of prognostic scales in upper gastrointestinal tract bleeding

IntroductionIn order to select high-risk patients, many prognostic scales have been invented. Among them, Rockall, Glasgow-Blatchford and AIMS 65 scales were considered the most useful.Material and methodsPatients with upper GI tract bleeding, treated between 2017 and 2018 were retrospectively enrolled to the study. Every patient had a Rockall, Glasgow-Blatchford and AIMS 65 score calculated retrospectively. Data on hospitalization as blood transfusions, length of hospital stay, rebleeding, intensive care unit (ICU) admission, mortality was included into data-base.ResultsUnivariate logistic regression revealed that only the AIMS65 scale was a prognostic factor for in-hospital mortality (OR 11.028; 95% CI: [2.271, 53.563], p=0.001). The AIMS 65 score >2 was the only factor predicting the need of >4 blood units transfusion during hospitalization (OR 3.977; 95% CI: [1.305, 12.122], p=0.015), whereas Glasgow-Blatchford scale >5 was the only risk factor for the need of fresh frozen plasma transfusion (OR 3.657; 95% CI: [1.010-13.242], p=0.048). The area under a curve (AUC) in the ROC analysis revealed that the AIMS 65 scale was the most accurate in mortality prediction (AUC=0.859, p=0.002), whereas Rockall score and Glasgow-Blatchford were not significant (AUC=0.614, p=0.093 and AUC=0.504, p=0.97, respectively).ConclusionsBased on our results, we recommend using AIMS 65 scoring system. It’s simple and requires few of parameters to be counted. Also, it proved to be the most efficient in predicting in-hospital mortality.