Clinical Endoscopy

Arunchai Chang

2 Articles

Prospective Comparison of the AIMS65 Score, Glasgow-Blatchford Score, and Rockall Score for Predicting Clinical Outcomes in Patients with Variceal and Nonvariceal Upper Gastrointestinal Bleeding: Arunchai Chang, Chokethawee Ouejiaraphant, Keerati Akarapatima, Attapon Rattanasupa, Varayu Prachayakul; Clin Endosc 2021;54(2):211-221. Published online July 16, 2020; DOI: https://doi.org/10.5946/ce.2020.068

Background
/Aims: This study aimed to determine the performance of the AIMS65 score (AIMS65), Glasgow-Blatchford score (GBS), and Rockall score (RS) in predicting outcomes in patients with upper gastrointestinal bleeding (UGIB), and to compare the results between patients with nonvariceal UGIB (NVUGIB) and those with variceal UGIB (VUGIB).
Methods
We conducted a prospective observational study between March 2016 and December 2017. Receiver operating characteristic curve analysis was performed for all outcomes for comparison. The associations of all three scores with mortality were evaluated using multivariate logistic regression analysis.
Results
Of the total of 337 patients with UGIB, 267 patients (79.2%) had NVUGIB. AIMS65 was significantly associated (odds ratio [OR], 1.735; 95% confidence interval [CI], 1.148–2.620), RS was marginally associated (OR, 1.225; 95% CI, 0.973–1.543), but GBS was not associated (OR, 1.017; 95% CI, 0.890–1.163) with mortality risk in patients with UGIB. However, all three scores accurately predicted all other outcomes (all p<0.05) except rebleeding (p>0.05). Only AIMS65 precisely predicted mortality, the need for blood transfusion and the composite endpoint (all p<0.05) in patients with VUGIB.
Conclusions
AIMS65 is superior to GBS and RS in predicting mortality in patients with UGIB, and also precisely predicts the need for blood transfusion and the composite endpoint in patients with VUGIB. No scoring system could satisfactorily predict rebleeding in all patients with UGIB.

Citations

Citations to this article as recorded by

Impact of duration to endoscopy in patients with non-variceal upper gastrointestinal bleeding: propensity score matching analysis of real-world data from Thailand
Arunchai Chang, Natthawat Sitthinamsuwan, Nuttanit Pungpipattrakul, Kittiphan Chienwichai, Keerati Akarapatima, Sorawat Sangkaew, Manus Rugivarodom, Attapon Rattanasupar, Bancha Ovartlarnporn, Varayu Prachayakul
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Successful Closure of a Benign Refractory Tracheoesophageal Fistula Using an Over-the-Scope Clip after Failed Esophageal Stent Placement and Surgical Management: Nonthalee Pausawasdi, Chotirot Angkurawaranon, Tanyaporn Chantarojanasiri, Arunchai Chang, Wanchai Wongkornrat, Somchai Leelakusolvong, Asada Methasate; Clin Endosc 2020;53(3):361-365. Published online October 28, 2019; DOI: https://doi.org/10.5946/ce.2019.106

Abstract PDF Supplementary Material PubReader ePub

Tracheoesophageal fistulas (TEFs) have traditionally been managed surgically, but the endoscopic approach is widely performed as a less invasive alternative. Different closure techniques have been proposed with inconsistent results. An over-the-scope clip (OTSC) appears to be a reasonable option, but long-term results have not been well defined. We report the long-term outcomes of a complex case of successful closure of a benign refractory TEF using an OTSC after failed surgical management and esophageal stent placement.

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Over-the-Scope Clip Closure of Persistent Gastrocutaneous Fistula After Percutaneous Endoscopic Gastrostomy Tube Removal: A Report of Two Cases
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Cureus.2021;[Epub] CrossRef
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