Emergency Medicine Wed 29 July 2020 Comparison of three scoring systems (aims 65 pre-endoscopic rockall glasgow blatchford) to predict 1 week outcome in patients presenting to emergency department with acute upper gastrointestinal bleeding
Researcher : Abhijith s
Research Guide : Praveen aggarwal
Institution Name : Aiims new delhi


Introduction: Upper gastrointestinal bleeding is a life-threatening GI emergency with a wide range of clinical severity. Appropriate triaging and stratification of patients is mandatory for quality care and appropriate use of resources. There are several risk assessment scoring systems, most of them rely on endoscopic results which therefore are not useful for emergency physicians. The major scoring systems that can be used in emergency are AIMS 65 score, Glasgow Blatchford scores and pre-endoscopic part of Rockall score. We studied the predictive value of each scoring system to predict 1 week outcome in patients presenting with upper gastrointestinal bleed Methodology : The study design is an ongoing prospective observational cohort study in high volume tertiary care centre . The sample size of 157 patients who presenting with UGI bleed of age >18yrs .Data collection started after getting ethical clearance. The primary objective is to compare the performance of three common scoring systems (AIMS 65, pre-endoscopic Rockall, Glasgow Blatchford) for predicting 1 week outcome in terms of mortality and Endoscopic haemostasis, recurrence of bleeding, length of hospital stay more than 7 days ,amount of packed red cells used for transfusion. Results : The Area under ROC curve for 1 week mortality calculated for AIMS 65 was 0.750; 95% confidence interval (CI) 1.47 to 4.8 showing good accuracy in comparison to pre endoscopic Rockall and Glasgow Blatchford. Receivers operating curve for prediction of rebleed by AIMS 65 score showed area under curve – 0.616 also was better than other two scoring systems. P value calculated for length of hospital stay found as 0.030 for AIMS 65 which showed its significance in predicting. The p value of Glasgow Blatchford for PRBC transfusion was found as close to zero, was better than AIMS 65 and pre endoscopic Rockall scores. Conclusion: In our study we found that AIMS 65 score was better in predicting one week mortality , length of hospital stay and rebleeding comparing to other scoring systems. Glasgow Blatchford predicted need of packed red blood cell transfusion better than AIMS 65 score and pre endoscopic Rockall score. I confirm the originality of the research work and that all fellow authors/researchers of this research work are aware and in agreement of this abstract submission.

DOI: 1596003584   Year of publication: 2020

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