Emergency endoscopy for acute gastrointestinal bleeding: Prognostic value of endoscopic hemostasis and the AIMS65 score in Japanese patients

Shotaro Nakamura, Takayuki Matsumoto, Hiroshi Sugimori, Motohiro Esaki, Takanari Kitazono, Makoto Hashizume

Research output: Contribution to journalArticle

Abstract

Background and Aim: To evaluate the prognostic factors, including risk scores (Glasgow-Blatchford score and AIMS65) in patients with acute upper or lower gastrointestinal bleeding. Methods: The medical records of patients who had undergone emergency gastrointestinal endoscopy for suspected gastrointestinal bleeding during the past 5 years were retrospectively analyzed. Results: A total of 232 endoscopies (130 esophagogastroduodenoscopies, 102 colonoscopies) for 192 patients met the inclusion criteria. Median age was 66 years, and 64% of patients were males. Endoscopy identified causes for bleeding in 173 patients (post-endoscopic interventions for neoplastic lesions in 36 cases, colonic diverticula in 34, gastroduodenal ulcers in 29, gastric erosions in 15, vascular ectasia in 14, post-biopsy bleeding in 13, malignant tumors in 10, inflammatory conditions in 9, esophagogastric varices in 5, Mallory-Weiss tears in 4, nasal bleedings in 3, and injury by swallowed blister pack in 1), whereas the source of bleeding remained obscure in 19 patients. Blood transfusion was given in 97 patients (51%), and 97 (51%) underwent endoscopic hemostasis. During the follow-up period, 49 patients (26%) experienced rebleeding 7 of whom were treated by interventional radiology. Thirty-nine patients (20%) died as result of various diseases. The probabilities of overall survival (OS) after 3 and 5 years were 71% and 67%, respectively. Cox multivariate analysis revealed blood transfusion, co-existing malignancy, absence of endoscopic hemostasis, and high AIMS65 score to be independent prognostic factors for poor OS. Conclusion: The AIMS65 score is useful for predicting the prognosis of patients with acute gastrointestinal bleeding.

Original languageEnglish
Pages (from-to)2676-2684
Number of pages9
JournalGASTROENTEROLOGICAL ENDOSCOPY
Volume57
Issue number12
Publication statusPublished - Jan 1 2015

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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