AIMS65评分在老年急性非静脉曲张上消化道出血中的应用

Applications of AIMS65 score for acute non-variceal upper gastrointestinal bleeding in the elderly

摘要:

目的 探讨AIMS65评分系统对老年非静脉曲张性上消化道出血患者(ANUGIB)再出血及死亡的预测价值。方法 回顾性分析北京老年医院消化内科2011年3月至2016年11月期间ANUGIB住院患者220例,根据AIMS65评分分为低危组(AIMS65评分＜2分)和高危组(AIMS65评分≥2分),比较两组死亡与存活、再出血与未再出血患者的AIMS65评分情况。采用SPSS 19.0统计软件对数据进行分析。计量资料用均数±标准差([AKx-D]±s)表示,两组比较采用t检验。计数资料用百分率表示,组间比较用χ²检验,Pearson相关性分析AIMS65评分与再出血和死亡的相关性。应用受试者工作特征(ROC)曲线下面积(AUC)评估AIMS65评分对再出血和死亡的预测价值。结果 再出血患者AIMS65评分高于未出血患者,差异有统计学意义[(3.82±1.55) vs (2.25±1.31); t=7.23,P＜0.05]。死亡患者AIMS65评分高于未死亡患者,差异有统计学意义[(4.65±1.23) vs (2.53±1.02); t=7.41,P＜0.05]。AIMS65评分与再出血及死亡呈正相关(r＝0.620,r＝0.863,P＜0.01)。AIMS65评分≥2分预测老年ANUGIB患者再出血及死亡的敏感度分别为85.71%和100.00%,特异度分别为34.04%和32.69%,AUC分别为0.719(95%CI:0.621～0.817)和0.892(95%CI:0.858～0.952) ,对再出血和死亡预测价值高(P＜0.01)。结论 AIMS65评分系统可用于对老年ANUGIB患者再出血和死亡的预测,值得临床推广。

Abstract:

Objective To investigate the value of AIMS65 score in the prediction of rebleeding and death for acute non-variceal upper gastrointestinal bleeding (ANUGIB) in the elderly. Methods A retrospective study was carried out on 220 elderly patients with ANUGIB admitted in our department from March 2011 to November 2016. According to the results of AIMS65 score, they were divided into low-risk group (<2) and high-risk group (≥2). The AIMS65 scores of those dead and survival and of those with rebleeding or not were evaluated. SPSS statistics 19.0 was used to analyze the data. The measurement data were expressed as mean±standard deviation ([AKx-D]±s), and students’ t test was employed for the comparison between groups. The enumeration data were expressed as a percentage, and the correlations of AIMS65 score with rebleeding and death were analyzed by Chi-square test and Pearson correlation analysis. The area under receiver-operating characteristic (ROC) curve was calculated to evaluate the predictive values of AIMS65 in rebleeding and death. Results The AIMS65 score was obviously higher in the patients with rebleeding than those without [(3.82±1.55) vs (2.25±1.31); t=7.23,P＜0.05], so was in the dead than the survival [(4.65±1.23) vs (2.53±1.02); t=7.41,P＜0.05]. The AIMS65 score was positively correlated with the rates of rebleeding and death (r=0.620, r=0.863, P<0.01). AIMS65 score ≥2 showed good values in the prediction of rebleeding and death, with the sensitivity 85.71% and 100.00%, the specificty 34.04% and 32.69%, and area under curve (AUC) 0.719(95%CI:0.621-0.817) and 0.892(95%CI:0.858-0.952), respectively (P<0.01). Conclusion AIMS65 score has better predictive values for rebleeding and death in the elderly ANUGIB patients, and it deserves popularization in clinical practice.