Clinical Endoscopy

Original Articles

Endoscopic versus surgical management for colonic volvulus hospitalizations in the United States: Dushyant Singh Dahiya, Abhilash Perisetti, Hemant Goyal, Sumant Inamdar, Amandeep Singh, Rajat Garg, Chin-I Cheng, Mohammad Al-Haddad, Madhusudhan R. Sanaka, Neil Sharma; Clin Endosc 2023;56(3):340-352. Published online April 17, 2023; DOI: https://doi.org/10.5946/ce.2022.166

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Background
/Aims: Colonic volvulus (CV), a common cause of bowel obstruction, often requires intervention. We aimed to identify hospitalization trends and CV outcomes in the United States.
Methods
We used the National Inpatient Sample to identify all adult CV hospitalizations in the United States from 2007 to 2017. Patient demographics, comorbidities, and inpatient outcomes were highlighted. Outcomes of endoscopic and surgical management were compared.
Results
From 2007 to 2017, there were 220,666 CV hospitalizations. CV-related hospitalizations increased from 17,888 in 2007 to 21,715 in 2017 (p=0.001). However, inpatient mortality decreased from 7.6% in 2007 to 6.2% in 2017 (p<0.001). Of all CV-related hospitalizations, 13,745 underwent endoscopic intervention, and 77,157 underwent surgery. Although the endoscopic cohort had patients with a higher Charlson comorbidity index, we noted lower inpatient mortality (6.1% vs. 7.0%, p<0.001), mean length of stay (8.3 vs. 11.8 days, p<0.001), and mean total healthcare charge ($68,126 vs. $106,703, p<0.001) compared to the surgical cohort. Male sex, increased Charlson comorbidity index scores, acute kidney injury, and malnutrition were associated with higher odds of inpatient mortality in patients with CV who underwent endoscopic management.
Conclusions
Endoscopic intervention has lower inpatient mortality and is an excellent alternative to surgery for appropriately selected CV hospitalizations.

Citations

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Navigating Abdominal Volvulus: A Comprehensive Review of Management Strategies
Simran Chauhan, Raju K Shinde, Yashraj Jain
Cureus.2024;[Epub] CrossRef
Clinicopathological Features of Elderly Patients with Colonic Volvulus
Mehmet Onur Gul, Selda Oğuz Aşlayan, Kadir Çorbacı, Aytaç Selman, Emre Berat Akçay, Oğuzhan Sunamak, Cebrail Akyüz
European Journal of Therapeutics.2024; 30(3): 303. CrossRef
Incidental Sigmoid Volvulus after a Ground-level Fall: An Unusual Case Report
Ziya Karimov, Elchin Shirinov, Gunay Huseynova, Mirhuseyn Mammadov, Meltem Songür Kodik
Caucasian Medical Journal.2023; 1(3): 36. CrossRef
Colonic Volvulus
Samantha L. Savitch, Calista M. Harbaugh
Clinics in Colon and Rectal Surgery.2023;[Epub] CrossRef

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Risk Stratification in Cancer Patients with Acute Upper Gastrointestinal Bleeding: Comparison of Glasgow-Blatchford, Rockall and AIMS65, and Development of a New Scoring System: Matheus Cavalcante Franco, Sunguk Jang, Bruno da Costa Martins, Tyler Stevens, Vipul Jairath, Rocio Lopez, John J. Vargo, Alan Barkun, Fauze Maluf-Filho; Clin Endosc 2022;55(2):240-247. Published online January 21, 2022; DOI: https://doi.org/10.5946/ce.2021.115

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Background
/Aims: Few studies have measured the accuracy of prognostic scores for upper gastrointestinal bleeding (UGIB) among cancer patients. Thereby, we compared the prognostic scores for predicting major outcomes in cancer patients with UGIB. Secondarily, we developed a new model to detect patients who might require hemostatic care.
Methods
A prospective research was performed in a tertiary hospital by enrolling cancer patients admitted with UGIB. Clinical and endoscopic findings were obtained through a prospective database. Multiple logistic regression analysis was performed to gauge the power of each score.
Results
From April 2015 to May 2016, 243 patients met the inclusion criteria. The AIMS65 (area under the curve [AUC] 0.85) best predicted intensive care unit admission, while the Glasgow-Blatchford score best predicted blood transfusion (AUC 0.82) and the low-risk group (AUC 0.92). All scores failed to predict hemostatic therapy and rebleeding. The new score was superior (AUC 0.74) in predicting hemostatic therapy. The AIMS65 (AUC 0.84) best predicted in-hospital mortality.
Conclusions
The scoring systems for prognostication were validated in the group of cancer patients with UGIB. A new score was developed to predict hemostatic therapy. Following this result, future prospective research should be performed to validate the new score.

Citations

Citations to this article as recorded by

Endoscopic Management of Tumor Bleeding
Frances Dang, Marc Monachese
Gastrointestinal Endoscopy Clinics of North America.2024; 34(1): 155. CrossRef
Clinical significance of D-dimer, antithrombin III, and Helicobacter pylori infection in acute upper gastrointestinal bleeding
Cong-Biao Cheng, Na Li
World Chinese Journal of Digestology.2024; 32(7): 501. CrossRef
The Accuracy of Pre-Endoscopic Scores for Mortality Prediction in Patients with Upper GI Bleeding and No Endoscopy Performed
Sergiu Marian Cazacu, Dragoș Ovidiu Alexandru, Răzvan-Cristian Statie, Sevastița Iordache, Bogdan Silviu Ungureanu, Vlad Florin Iovănescu, Petrică Popa, Victor Mihai Sacerdoțianu, Carmen Daniela Neagoe, Mirela Marinela Florescu
Diagnostics.2023; 13(6): 1188. CrossRef
Progress in the Evaluation of Acute Upper Gastrointestinal Bleeding with AIMS65 Scoring System
莉王
Advances in Clinical Medicine.2023; 13(05): 8163. CrossRef
Interpretations of the Role of Plasma Albumin in Prognostic Indices: A Literature Review
Kim Oren Gradel
Journal of Clinical Medicine.2023; 12(19): 6132. CrossRef

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Acute Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review and Meta-Analysis: Umair Iqbal, Hafsa Anwar, Hafiz Umair Siddiqui, Muhammad Ali Khan, Faisal Kamal, Bradley D. Confer, Harshit S. Khara; Clin Endosc 2021;54(4):534-541. Published online June 25, 2021; DOI: https://doi.org/10.5946/ce.2021.071

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Background
/Aims: More than 100 million people to date have been affected by the coronavirus disease-2019 (COVID-19) pandemic. Patients with COVID-19 have a higher risk of bleeding complications. We performed a systematic review and meta-analysis to evaluate the outcomes of COVID-19 patients with signs and symptoms of acute gastrointestinal bleeding (GIB).
Methods
A systematic literature search was carried out for articles published until until November 11, 2020, in the Embase, MEDLINE, Web of Science, and Cochrane Library databases. We included studies on COVID-19 patients with signs and symptoms of GIB.
Results
Our search yielded 49 studies, of which eight with a collective 127 patients (86 males and 41 females) met our inclusion criteria. Conservative management alone was performed in 59% of the patients, endoscopic evaluation in 31.5%, and interventional radiology (IR) embolization in 11%. Peptic ulcer disease was the most common endoscopic finding, diagnosed in 47.5% of the patients. Pooled overall mortality was 19.1% (95% confidence interval [CI]; 12.7%-27.6%) and pooled mortality secondary to GIB was 3.5% (95% CI; 1.3%–9.1%). The pooled risk of rebleeding was 11.3% (95% CI; 6.8%–18.4%).
Conclusions
The majority of COVID-19 patients with GIB responded to conservative management, with a low mortality rate associated with GIB and the risk of rebleeding. Thus, we suggest limiting endoscopic and IR interventions to those with hemodynamic instability and those for whom conservative management was unsuccessful.

Citations

Citations to this article as recorded by

Prevalence and outcomes of upper gastrointestinal bleeding in COVID‐19: A systematic review and meta‐analysis
Sawai Singh Rathore, Zario Shai Wint, Aman Goyal, Bijay Mukesh Jeswani, Ameer Mustafa Farrukh, María Alejandra Nieto‐Salazar, Thanmai Reddy Thugu, Snigdha Erva, Raafay Mehmood, Adriana Carolina Toro‐velandia, Hamam Aneis, Sunny Ratnani, Ibrahim Marouf Yas
Reviews in Medical Virology.2024;[Epub] CrossRef
Inpatient outcomes of inflammatory bowel disease in hospitalized patients with COVID-19: analysis of a nationally representative sample
Mohammad Aldiabat, Saqr Alsakarneh, Tyrell Daniel, Muhammad Ali Butt, Balaji Jagdish, James Rock, Aarushi Sudan, Majd Al-Ahmad, Ahmad Jabri, Yassine Kilani, Tarek Odah, Laith Alhuneafat, Mir Zulqarnain, Jana G. Hashash, Hassan Ghoz
Baylor University Medical Center Proceedings.2024; 37(2): 239. CrossRef
Increasing inpatient mortality of nonvariceal upper gastrointestinal bleeding during the COVID-19 pandemic: a nationwide retrospective cohort study
Waqas Rasheed, Gnanashree Dharmarpandi, Ola Al-Jobory, Anass Dweik, Muhammad Anil, Sameer Islam
Baylor University Medical Center Proceedings.2023; 36(3): 286. CrossRef
Outcomes in Patients Admitted for Upper Gastrointestinal Bleeding and COVID-19 Infection: A Study of Two Years of the Pandemic
Sergiu Cazacu, Daniela Burtea, Vlad Iovănescu, Dan Florescu, Sevastița Iordache, Adina Turcu-Stiolica, Victor Sacerdotianu, Bogdan Ungureanu
Life.2023; 13(4): 890. CrossRef
Prevalence, causes, medical interventions, and mortality outcome of acute gastrointestinal bleeding among COVID-19 inpatients
Mai N. Luu, Thinh P. Dang, Minh-Cong H. Vo, Duc T. Quach
Current Medical Research and Opinion.2023; 39(5): 731. CrossRef
Gastrointestinal Bleeding in Patients With New Coronavirus Infection COVID-19
V. D. Anosov, S. A. Domrachev, S. V. Ovchinnikov, N. O. Solovyov
Russian Sklifosovsky Journal "Emergency Medical Care".2023; 12(3): 458. CrossRef
Clinical and Endoscopic Outcomes in COVID-19 Patients With Gastrointestinal Bleeding
Hassan Ashktorab, Tiziano Russo, Gholamreza Oskrochi, Giovanni Latella, Sara Massironi, Martina Luca, Lakshmi G. Chirumamilla, Adeyinka O. Laiyemo, Hassan Brim
Gastro Hep Advances.2022; 1(4): 487. CrossRef
Clinical Characteristics of Hospitalized COVID-19 Patients Who Have Gastrointestinal Bleeds Requiring Intervention: A Case-Control Study
Ahmad Abulawi, Ali Al-Tarbsheh, Annie Leamon, Paul Feustel, Amit Chopra, Asra Batool
Cureus.2022;[Epub] CrossRef
Clinical features of thrombosis and bleeding in COVID-19
Mari R. Thomas, Marie Scully
Blood.2022; 140(3): 184. CrossRef
Mortality Rate in Upper Gastrointestinal Bleeding Associated with Anti-Thrombotic Therapy Before and During Covid-19 Pandemic
Petrica Popa, Sevastita Iordache, Dan Nicolae Florescu, Vlad Florin Iovanescu, Alexandru Vieru, Valentin Barbu, Maria-Cristina Bezna, Dragos Ovidiu Alexandru, Bogdan Silviu Ungureanu, Sergiu Marian Cazacu
Journal of Multidisciplinary Healthcare.2022; Volume 15: 2679. CrossRef
Coronavirus Disease in the Abdomen
Mark A. Anderson, Mark A. Khauli, Reece J. Goiffon, Avinash Kambadakone
Advances in Clinical Radiology.2022; 4(1): 25. CrossRef
Сauses, risk factors, diagnostics and treatment of gastrointestinal bleeding in patients with a novel coronavirus infection (COVID-19)
A. A. Sheptulin, S. S. Kardasheva, A. A. Kurbatova
Clinical Medicine (Russian Journal).2022; 100(7-8): 341. CrossRef
The frequency of ulcerative-erosive defects and ulcerative bleeding of the gastroduodenal zone in patients with coronavirus infection COVID-19
N. N. Butorin, V. V. Tsukanov, R. V. Asyayev, M. N. Butorina, A. V. Vasyutin, J. L. Tonkikh
Experimental and Clinical Gastroenterology.2022; (5): 5. CrossRef

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Seasonal Impacts on the Incidence of Esophageal Variceal Hemorrhage: A Nationwide Analysis across a Decade: Mohamed Tausif Siddiqui, Mohammad Bilal, Khwaja Fahad Haq, Christopher Nabors, Beth Schorr-Lesnick, David C. Wolf; Clin Endosc 2020;53(2):189-195. Published online December 27, 2019; DOI: https://doi.org/10.5946/ce.2019.094

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Background
/Aims: Seasonal variation has previously been reported in relation to the incidence of non-variceal upper gastrointestinal bleeding; however, the impact of seasonal variation on variceal bleeding is not known.
Methods
We conducted a cross-sectional study using the Nationwide Inpatient Sample database from 2005 to 2014. International Classification of Diseases, Clinical Modification- 9th Revision codes were used to identify patients hospitalized with a primary or secondary diagnosis of esophageal variceal hemorrhage. The data were analyzed based on the month of hospitalization. Our primary aim was to assess seasonal variations in variceal bleeding-related hospitalizations. The secondary aims were to assess the impact of seasonal variation on outcomes in variceal bleeding including in-hospital mortality and healthcare resource utilization.
Results
A total of 348,958 patients hospitalized with esophageal variceal bleeding were included. The highest number of hospitalizations was reported in December (99.3/day) and the lowest was reported in June (90.8/day). In-hospital mortality was highest in January (11.5%) and lowest in June (9.8%). There was no significant difference in hospital length of stay or total hospitalization costs across all months in all years combined.
Conclusions
There appears to be a seasonal variation in the incidence and mortality of variceal hemorrhage in the United States. December was the month with the highest number of daily hospitalizations while the nadir occurred in June.

Citations

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Assessing the Predictive Factors for Bleeding in Esophageal Variceal Disease: A Systematic Review
Camila Guinazu, Adolfo Fernández Muñoz, Maria D Maldonado, Jeffry A De La Cruz, Domenica Herrera, Victor S Aruana, Ernesto Calderon Martinez
Cureus.2023;[Epub] CrossRef
α-Adrenergic blockade prevented environmental temperature reduction-induced transient portal pressure surge in cirrhotic and portal hypertensive rats
Hui-Chun Huang, Ching-Chih Chang, Chon Kit Pun, Ming-Hung Tsai, Chiao-Lin Chuang, Shao-Jung Hsu, Yi-Hsiang Huang, Ming-Chih Hou, Fa-Yauh Lee
Clinical Science.2022; 136(20): 1449. CrossRef
Establishment and Evaluation of a Time Series Model for Predicting the Seasonality of Acute Upper Gastrointestinal Bleeding
Zhaoli Fu, Xujie Xi, Beiping Zhang, Yanfeng Lin, Aling Wang, Jianmin Li, Ming Luo, Tianwen Liu
International Journal of General Medicine.2021; Volume 14: 2079. CrossRef
Are there Seasonal Variations in the Incidence and Mortality of Esophageal Variceal Bleeding?
Jeong Ill Suh
Clinical Endoscopy.2020; 53(2): 107. CrossRef

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A Nationwide Assessment of the “July Effect” and Predictors of Post-Endoscopic Retrograde Cholangiopancreatography Sepsis at Urban Teaching Hospitals in the United States: Rupak Desai, Upenkumar Patel, Shreyans Doshi, Dipen Zalavadia, Wardah Siddiq, Hitanshu Dave, Mohammad Bilal, Vikas Khullar, Hemant Goyal, Madhav Desai, Nihar Shah; Clin Endosc 2019;52(5):486-496. Published online May 27, 2019; DOI: https://doi.org/10.5946/ce.2018.190

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Background
/Aims: To analyze the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) sepsis in the early (July to September) and later (October to June) academic months to assess the “July effect”.
Methods
The National Inpatient Sample (2010–2014) was used to identify ERCP-related adult hospitalizations at urban teaching hospitals by applying relevant procedure codes from the International Classification of Diseases, 9th revision, Clinical Modification. Post-ERCP outcomes were compared between the early and later academic months. A multivariate analysis was performed to evaluate the odds of post-ERCP sepsis and its predictors.
Results
Of 481,193 ERCP procedures carried out at urban teaching hospitals, 124,934 were performed during the early academic months. The demographics were comparable for ERCP procedures performed during the early and later academic months. A higher incidence (9.4% vs. 8.8%, p<0.001) and odds (odds ratio [OR], 1.07) of post-ERCP sepsis were observed in ERCP performed during the early academic months. The in-hospital mortality rate (7% vs. 7.5%, p=0.072), length of stay, and total hospital charges in patients with post-ERCP sepsis were also equivalent between the 2 time points. Pre-ERCP cholangitis (OR, 3.20) and post-ERCP complications such as cholangitis (OR, 6.27), perforation (OR, 3.93), and hemorrhage (OR, 1.42) were significant predictors of higher post-ERCP sepsis in procedures performed during the early academic months.
Conclusions
The July effect was present in the incidence of post-ERCP sepsis, and academic programs should take into consideration the predictors of post-ERCP sepsis to lower health-care burden.

Citations

Citations to this article as recorded by

A Nationwide Study of the “July Effect” Concerning Postpartum Hemorrhage and Its Risk Factors at Teaching Hospitals across the United States
Zahra Shahin, Gulzar H. Shah, Bettye A. Apenteng, Kristie Waterfield, Hani Samawi
Healthcare.2023; 11(6): 788. CrossRef
July effect in clinical outcomes of esophagogastroduodenoscopy performed at teaching hospitals in the United States
Karthik Gangu, Sanket Basida, Rehmat Ullah Awan, Mohammad Ali Butt, Austin Reed, Rao Afzal, Rahul Shekhar, Harleen Kaur Chela, Ebubekir S. Daglilar, Abu Baker Sheikh
Baylor University Medical Center Proceedings.2023; 36(4): 478. CrossRef
Increased ERCP volume improves cholangiogram interpretation: a new performance measure for ERCP training?
Shyam Vedantam, Sunil Amin, Ben Maher, Saqib Ahmad, Shanil Kadir, Saad Khalid Niaz, Mark Wright, Nadeem Tehami
Clinical Endoscopy.2022; 55(3): 426. CrossRef
Post-ERCP Pancreatitis: Prevention, Diagnosis and Management
Oscar Cahyadi, Nadeem Tehami, Enrique de-Madaria, Keith Siau
Medicina.2022; 58(9): 1261. CrossRef
Risk factors for infections after endoscopic retrograde cholangiopancreatography (ERCP): a retrospective cohort analysis of US Medicare Fee-For-Service claims, 2015–2021
Susan Hutfless, Yasutoshi Shiratori, Daniel Chu, Simon Liu, Anthony Kalloo
BMJ Open.2022; 12(9): e065077. CrossRef
Clinical coaches and patient safety – Just in time: A descriptive exploratory study
Lorraine Thompson, Frances Lin, Annette Faithfull-Byrne, Judith Gonzalez, Amanda Naumann, Kathryn Geisler, Cheryle Moss
Nurse Education in Practice.2021; 54: 103134. CrossRef
Is the July Effect Real in Patients Undergoing Endoscopic Retrograde Cholangiopancreatography?
Tae Yoon Lee, Yousuke Nakai
Clinical Endoscopy.2019; 52(5): 399. CrossRef

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Predictors of Rebleeding in Upper Gastrointestinal Dieulafoy Lesions: Sang-Hun Park, Du-Hyeon Lee, Chang-Hwan Park, Jin Jeon, Ho-Jun Lee, Sung-Uk Lim, Seon-Young Park, Hyun-Soo Kim, Sung-Kyu Choi, Jong-Sun Rew; Clin Endosc 2015;48(5):385-391. Published online September 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.5.385

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Background/Aims

Dieulafoy lesions (DLs) are a rare but significant cause of upper gastrointestinal bleeding. We aimed to define the clinical significance of rebleeding and identify the predictors of rebleeding and mortality in upper gastrointestinal Dieulafoy lesions (UGIDLs).

Methods

Patients diagnosed with UGIDLs between January 2004 and June 2013 were retrospectively evaluated. Multivariate logistic regression analyses were performed to define the predictors of rebleeding and mortality in patients with UGIDLs.

Results

The study group consisted of 81 male and 36 female patients. Primary hemostasis was achieved in 115 out of 117 patients (98.3%) with various endoscopic therapies. Rebleeding occurred in 10 patients (8.5%). The mortality rate was significantly higher in patients with rebleeding than in those without rebleeding (30.0% vs. 4.7%, p=0.020). Multivariate logistic regression analysis revealed that kidney disease (p=0.006) and infection (p=0.005) were significant predictors of rebleeding in UGIDLs and that kidney disease (p=0.004) and platelet count (p=0.013) were significant predictors of mortality.

Conclusions

Rebleeding has an important prognostic significance in patients with UGIDLs. Kidney disease and infection are major predictors of rebleeding and mortality in patients with UGIDLs.

Citations

Citations to this article as recorded by

Clinical outcomes of Dieulafoy's lesion compared with peptic ulcer in upper gastrointestinal bleeding
Sang Yong Jo, Jin Hee Noh, Boram Cha, Ji Yong Ahn, Seung‐pyo Oh, Jun‐young Seo, Hee Kyong Na, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon‐Yong Jung
Journal of Gastroenterology and Hepatology.2023; 38(6): 888. CrossRef
Intragastric Single-Port Surgery: An Innovative and Multipurpose Technique for the Therapy of Upper Digestive Tract Lesions
Renjie Li, Wilfried Veltzke-Schlieker, Andreas Adler, Mahmoud Ismail, Harun Badakhshi, Ricardo Zorron
Surgical Innovation.2022; 29(1): 56. CrossRef
Outcomes in Severe Upper GI Hemorrhage from Dieulafoy’s Lesion with Monitoring of Arterial Blood Flow
B. Nulsen, D. M. Jensen, T. O. G. Kovacs, K. A. Ghassemi, M. Kaneshiro, G. S. Dulai, R. Jutabha, J. A. Gornbein
Digestive Diseases and Sciences.2021; 66(10): 3495. CrossRef
Hybrid surgical technologies in the treatment of patients with Dieulafoy’s lesion complicated by recurrent gastrointestinal bleeding
S.E. Voskanyan, M.V. Shabalin, A.I. Artemyev, I.Yu. Kolyshev, Z. Bogoevich, A.N. Bashkov, E.V. Naidenov
Endoskopicheskaya khirurgiya.2020; 26(1): 40. CrossRef
Dieulafoy Lesion: Predictive Factors of Early Relapse and Long-Term Follow-Up
Paulo Massinha, Inês Cunha, Luís Tomé
GE - Portuguese Journal of Gastroenterology.2020; 27(4): 237. CrossRef
A Rare Cause of Gastrointestinal Bleeding in a 65-Year-Old Man with History of Polycythemia Vera
Najmeh Aletaha, Hoda Hamid, Niloofar Ayoobi Yazdi, Reza Taslimi, Bijan Shahbazkhani, Pardis Ketabi Moghadam
Middle East Journal of Digestive Diseases.2019; 11(4): 225. CrossRef
Lesión de Dieulafoy en estómago como causa de sangrado gastrointestinal alto: presentación de un caso
Jairo Alonso Sierra-Avendaño, Fabián Andrés Mejía-Casadiegos, María Paula Pérez-Barón, Gabriel Eduardo Pérez-García
Revista Médicas UIS.2019; 32(1): 27. CrossRef
Endoscopic Management of Nonvariceal, Nonulcer Upper Gastrointestinal Bleeding
Michael A. Chang, Thomas J. Savides
Gastrointestinal Endoscopy Clinics of North America.2018; 28(3): 291. CrossRef
Refractory Gastric Hemorrhage from Caliber Persistent Arteries of the Left Inferior Phrenic Artery
Takahiro Hosoi, Norihiro Yuasa, Eiji Takeuchi, Hideo Miyake, Hidemasa Nagai, Yuichiro Yoshioka, Masataka Okuno, Takayuki Minami, Kanji Miyata, Masahiko Fujino
The Japanese Journal of Gastroenterological Surgery.2017; 50(2): 112. CrossRef

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Clinical Application of AIMS65 Scores to Predict Outcomes in Patients with Upper Gastrointestinal Hemorrhage: Ragesh Babu Thandassery, Manik Sharma, Anil K John, Khalid Mohsin Al-Ejji, Hamidulla Wani, Khaleel Sultan, Muneera Al-Mohannadi, Rafie Yakoob, Moutaz Derbala, Nazeeh Al-Dweik, Muhammed Tariq Butt, Saad Rashid Al-Kaabi; Clin Endosc 2015;48(5):380-384. Published online September 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.5.380

Abstract PDF PubReader ePub

Background/Aims

To evaluate the ability of the recently proposed albumin, international normalized ratio (INR), mental status, systolic blood pressure, age >65 years (AIMS65) score to predict mortality in patients with acute upper gastrointestinal bleeding (UGIB).

Methods

AIMS65 scores were calculated in 251 consecutive patients presenting with acute UGIB by allotting 1 point each for albumin level <30 g/L, INR >1.5, alteration in mental status, systolic blood pressure ≤90 mm Hg, and age ≥65 years. Risk stratification was done during the initial 12 hours of hospital admission.

Results

Intensive care unit (ICU) admission, endoscopic therapy, or surgery were required in 51 patients (20.3%), 64 (25.5%), and 12 (4.8%), respectively. The predictive accuracy of AIMS65 scores ≥2 was high for blood transfusion (area under the receiver operator characteristic curve [AUROC], 0.59), ICU admission (AUROC, 0.61), and mortality (AUROC, 0.74). The overall mortality was 10.3% (n=26), and was 3%, 7.8%, 20%, 36%, and 40% for AIMS65 scores of 0, 1, 2, 3, and 4, respectively; these values were significantly higher in those with scores ≥2 (30.9%) than in those with scores <2 (4.5%, p<0.001).

Conclusions

AIMS65 is a simple, accurate, non-endoscopic risk score that can be applied early (within 12 hours of hospital admission) in patients with acute UGIB. AIMS65 scores ≥2 predict high in-hospital mortality.

Citations

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The Prediction and Treatment of Bleeding Esophageal Varices in the Artificial Intelligence Era: A Review
María Isabel Murillo Pineda, Tania Siu Xiao, Edgar J Sanabria Herrera, Alberto Ayala Aguilar, David Arriaga Escamilla, Alejandra M Aleman Reyes, Andreina D Rojas Marron, Roberto R Fabila Lievano, Jessica J de Jesús Correa Gomez, Marily Martinez Ramirez
Cureus.2024;[Epub] CrossRef
ASSESSMENT OF PATIENTS WITH NON-VARICEAL UPPER GASTROINTESTINAL BLEEDING USING AIMS65 SCORE
Farahnaz Joukar, Raheleh Sadat Hosseini Basti, Fakhrieh Sadat Hosseini Basti, Fatemeh Mosafer, Hoorieh Sadat Hosseini Basti, Zahra Hedayatzadeh, Afshin Shafaghi
Studies in Medical Sciences.2024; 35(1): 51. CrossRef
Clinical Outcomes of Patients with Benign Peptic Ulcer Bleeding After an Emergency Endoscopy Based on Patient Location
Boram Cha, Jin Hee Noh, Ji Yong Ahn, Jun Su Lee, Ga Hee Kim, Hee Kyong Na, Kee Wook Jung, Jeong Hoon Lee, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
Digestive Diseases and Sciences.2023; 68(4): 1539. CrossRef
Utility of the CANUKA Scoring System in the Risk Assessment of Upper GI Bleeding
Sara Goff, Emily Friedman, Butros Toro, Matthew Almonte, Carlie Wilson, Xiaoning Lu, Daohai Yu, Frank Friedenberg
Journal of Clinical Gastroenterology.2023; 57(6): 595. CrossRef
Outcomes in Patients Admitted for Upper Gastrointestinal Bleeding and COVID-19 Infection: A Study of Two Years of the Pandemic
Sergiu Cazacu, Daniela Burtea, Vlad Iovănescu, Dan Florescu, Sevastița Iordache, Adina Turcu-Stiolica, Victor Sacerdotianu, Bogdan Ungureanu
Life.2023; 13(4): 890. CrossRef
Frailty predicts mortality in patients with upper gastrointestinal bleed: a prospective cohort study
Mohammed Affan Guliyara, Goktug Ermerak, Miriam Levy, Jenn Hian Koo, Milan Bassan
Journal of Gastroenterology and Hepatology.2023; 38(8): 1292. CrossRef
Real world utilization of Andexanet alfa in the management of oral factor Xa inhibitor-associated gastrointestinal bleeding
Caitlin S. Brown, Alicia E. Mattson, Daniel Cabrera, Nayantara Coelho-Prabhu, Alejandro A. Rabinstein, Theresa Dettling, Robert D. McBane, Fernanda Bellolio
The American Journal of Emergency Medicine.2023; 73: 1. CrossRef
Lower mortality with andexanet alfa vs 4-factor prothrombin complex concentrate for factor Xa inhibitor-related major bleeding in a U.S. hospital-based observational study
Paul P. Dobesh, Gregory J. Fermann, Mary J. Christoph, Bruce Koch, Eva Lesén, Hungta Chen, Belinda Lovelace, Theresa Dettling, Mark Danese, Julie Ulloa, Sherry Danese, Craig I. Coleman
Research and Practice in Thrombosis and Haemostasis.2023; 7(6): 102192. CrossRef
The Reduction of After-Hours and Weekend Effects in Upper Gastro-intestinal Bleeding Mortality During the COVID-19 Pandemic Compared to the Pre-Pandemic Period
Sergiu Marian Cazacu, Adina Turcu-Stiolica, Dan Nicolae Florescu, Bogdan Ungureanu, Vlad Florin Iovanescu, Carmen Daniela Neagoe, Daniela Burtea, Amelia Valentina Genunche-Dumitrescu, Taina Elena Avramescu, Sevastita Iordache
Journal of Multidisciplinary Healthcare.2023; Volume 16: 3151. CrossRef
The effect of aspirin in patients with nonvaricose upper gastrointestinal bleeding and risk factors analysis
Ding Peng, Mei Zhang
Scandinavian Journal of Gastroenterology.2022; 57(2): 149. CrossRef
Gastrointestinal Disease in the Population Aged 80 Years and above in Korea during Recent Decades: Multi-center Cross-sectional Study
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Has Any Improvement been Made in the Clinical Outcome of Patients with Bleeding Peptic Ulcer in the Part 10 Years?: Jin Wook Choi, M.D., Hak Yang Kim, M.D., Kyung Ho Kim, M.D., Ja Young Lee, M.D.,Gwang Ho Baek, M.D., Myoung Kuk Jang, M.D., Joon Young Park, M.D.,Jin Heon Lee, M.D. and Jae Young Yoo, M.D.; Korean J Gastrointest Endosc 2005;30(5):235-242. Published online May 30, 2005

Abstract PDF: Background
/Aims: Bleeding still remains as one of the major medical problems in peptic ulcer diseases, despite of the advances in therapeutic options and endoscopic therapy. The aim of this study was to compare the clinical outcomes of bleeding peptic ulcer between two distinct periods in the past ten years. Methods: We divided the among 10 years, we selected the two distinct periods; the first (1993∼1995) and the second (2000∼2002). The clinical and endoscopic characteristics in patients with bleeding peptic ulcer were compared between the two periods. We also analyzed the changes in the clinical outcomes as well. Results: The age of patients during the second period was significantly older compare to the first period. In subgroup analysis, proportions of patients older than 60 years and of female patients were significantly higher in the second period. The percentage of the patients with co-morbid illness, such as diabetes mellitus, cardiovascular diseases, or users of non-steroidal anti- inflammatory drugs, was higher in the second period. Despite the decreasing the frequency of urgent surgery in the second period, there was no significant difference in the rate of re-bleeding and mortality between both periods. Conclusions: Despite the advances in therapeutic options in the second period, no significant difference was found in the prognosis of bleeding ulcer, compared to the first period. Old age, co-morbid illness, and increasing usage of NSAIDs has may contributed to this. Taken together, it might be more important to apply preventive measures to the patients who have risk factors for bleeding peptic ulcer. (Korean J Gastrointest Endosc 2005;30:235⁣242)

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