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AIMS65评分是预测非静脉曲张性上消化道出血患者死亡率的有效指标:AIMS65评分高的患者需紧急内镜检查。

The AIMS65 Score Is a Useful Predictor of Mortality in Patients with Nonvariceal Upper Gastrointestinal Bleeding: Urgent Endoscopy in Patients with High AIMS65 Scores.

作者信息

Park Sun Wook, Song Young Wook, Tak Dae Hyun, Ahn Byung Moo, Kang Sun Hyung, Moon Hee Seok, Sung Jae Kyu, Jeong Hyun Yong

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.

出版信息

Clin Endosc. 2015 Nov;48(6):522-7. doi: 10.5946/ce.2015.48.6.522. Epub 2015 Nov 30.

Abstract

BACKGROUND/AIMS: To validate the AIMS65 score for predicting mortality of patients with nonvariceal upper gastrointestinal bleeding and to evaluate the effectiveness of urgent (<8 hours) endoscopic procedures in patients with high AIMS65 scores.

METHODS

This was a 5-year single-center, retrospective study. Nonvariceal, upper gastrointestinal bleeding was assessed by using the AIM65 and Rockall scores. Scores for mortality were assessed by calculating the area under the receiver-operating characteristic curve (AUROC). Patients with high AIMS65 scores (≥2) were allocated to either the urgent or non-urgent endoscopic procedure group. In-hospital mortality, success of endoscopic procedure, recurrence of bleeding, admission period, and dose of transfusion were compared between groups.

RESULTS

A total of 634 patients were analyzed. The AIMS65 score successfully predicted mortality (AUROC=0.943; 95% confidence interval [CI], 0.876 to 0.99) and was superior to the Rockall score (AUROC=0.856; 95% CI, 0.743 to 0.969) in predicting mortality. The group with high AIMS65 score included 200 patients. The urgent endoscopic procedure group had reduced hospitalization periods (p<0.05).

CONCLUSIONS

AIMS65 score may be useful in predicting mortality in patients with nonvariceal upper gastrointestinal bleeding. Urgent endoscopic procedures in patients with high scores may be related to reduced hospitalization periods.

摘要

背景/目的:验证AIMS65评分对非静脉曲张性上消化道出血患者死亡率的预测价值,并评估高AIMS65评分患者进行紧急(<8小时)内镜治疗的有效性。

方法

这是一项为期5年的单中心回顾性研究。采用AIM65和Rockall评分评估非静脉曲张性上消化道出血情况。通过计算受试者工作特征曲线下面积(AUROC)评估死亡率评分。将AIMS65评分高(≥2)的患者分为紧急内镜治疗组或非紧急内镜治疗组。比较两组患者的院内死亡率、内镜治疗成功率、出血复发率、住院时间和输血量。

结果

共分析634例患者。AIMS65评分成功预测了死亡率(AUROC=0.943;95%置信区间[CI],0.876至0.99),在预测死亡率方面优于Rockall评分(AUROC=0.856;95%CI,0.743至0.969)。AIMS65评分高的组包括200例患者。紧急内镜治疗组的住院时间缩短(p<0.05)。

结论

AIMS65评分可能有助于预测非静脉曲张性上消化道出血患者的死亡率。高评分患者进行紧急内镜治疗可能与缩短住院时间有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5b8/4676659/10aecc4f1497/ce-48-6-522f1.jpg

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