There was also no significant increase in length of stay or the need for ICU. There was a lower hemoglobin on admission for both the APA group (89 g/L [79–110],
p < 0.0001) and the ACA group (97 g/L [76–110], p = 0.04) compared to those on neither agent (110 g/L [85–130]). There were higher packed red blood cell transfusion requirements for both the APA group (2 units [0–4], p = 0.0005) and the ACA group (2 units [0–5], p = 0.03) compared to those on neither agent (0 units [0–3]). The APA group had higher pre-endoscopic Rockall (4 [3–5], p < 0.0001), post-endoscopic Rockall (5 [4–6], p < 0.0001) and Blatchford (10 [7–13], p < 0.0001) scores. Similarly, the ACA group had higher pre-endoscopic Rockall (4 [3–5], p < 0.002), post-endoscopic Rockall (5 [3–7], Selleckchem AZD6244 p < 0.03) and Blatchford (10 [7–14], p < 0.001) scores. Conclusion: Patients who present with UGI bleeding on antiplatelet or anticoagulant therapy are older, selleck screening library more likely to have major comorbidities, have a lower haemoglobin on admission, score higher on traditional triage scoring systems and have higher transfusion requirements. However, their inpatient hospital outcomes are not different to the younger, healthier patients who are not on these agents. M ROBERTSON, A MAJUMDAR, R BOYAPATI, W CHUNG, R TERBAH, T WORLAND, J WEI, S LONTOS, R VAUGHAN Department of Gastroenterology and Liver
Transplant Unit, Austin Hospital, Heidelberg, Australia Introduction: The American College of Gastroenterology along with multiple international consensus guidelines recommend early risk stratification in patients presenting with upper gastrointestinal bleeding (UGIB). Multiple algorithms predicting outcomes in UGIB have been developed, the most widely used of which are the Glasgow-Blatchford (GBS) and Rockall scores. AIMS65 is a novel risk stratification score1
recently validated Lepirudin to predict inpatient mortality, although its predictive accuracy has not been compared with both GBS and Rockall scores. AIMS65 assigns 1 point for: albumin level <30 g/L, INR > 1.5, altered mental status, systolic blood pressure <90 mmHg and age older than 65 years. Compared with existing scores, AIMS65 has the advantages of not being weighted and can be calculated with pathology values routinely obtainable in the emergency department. Objective: To validate AIMS65 as a predictor of inpatient mortality in patients presenting with acute UGIB and to compare AIMS65 with established GBS and pre-endoscopy Rockall scores. Methods: ICD-10 codes were used to identify patients presenting with UGIB requiring endoscopy to the Austin Hospital, a tertiary referral centre, over a 42-month period from 2010 to 2013. Patients were excluded if data required for calculation of risk stratification scores were incomplete or if medical records revealed an alternative diagnosis. All patients were risk stratified using AIMS65, GBS and Rockall scores. The primary outcome was inpatient mortality.