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

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.