Abstract

Background: Upper gastrointestinal bleeding (UGIB) is a serious complication in cardiovascular patients receiving antithrombotic therapy. The aim of this study was to evaluate the prognostic value of the Glasgow-Blatchford Score (GBS) and AIMS65 in these patients.

Methods: A total of 76 cardiovascular patients on antithrombotic therapy who experienced UGIB confirmed by endoscopy were admitted for treatment at Hue University of Medicine and Pharmacy Hospital and Hue Central Hospital. The patients’ clinical outcomes during hospitalization were assessed using the GBS and AIMS65 scores.

Results: The mean age of the 76 patients was 71.37 ± 13.65 years, with a male-to-female ratio of 1.45:1. Over 80% of UGIB patients were taking antiplatelet therapy (APT), 9.2% were on vitamin K antagonists (VKA), and 10.5% were on direct oral anticoagulants (DOACs). The main causes of UGIB were gastric and duodenal ulcers. The mean GBS and AIMS65 scores were 11.07 ± 3.43 and 1.22 ± 0.89, respectively. The GBS score had good predictive value for blood transfusion needs, with an AUC of 0.780 (95% CI: 0.655–0.906), especially in the APT group (AUC: 0.797; 95% CI: 0.652–0.942). GBS was also superior to AIMS65 in predicting ICU admission (AUC: 0.873 vs. 0.718), particularly among patients using DOACs. Both GBS and AIMS65 were predictive of rebleeding (AUC: 0.846 and 0.797, respectively), but only AIMS65 showed significant predictive value for rebleeding in patients on APT (AUC: 0.810; 95% CI: 0.683–0.937). Both scores also demonstrated good prognostic value for mortality, with AUCs of 0.861 for GBS and 0.837 for AIMS65.

Conclusion: GBS and AIMS65 have good prognostic value for predicting complications and clinical outcomes during hospitalization in UGIB patients on antithrombotic therapy. In patients using antiplatelet agents, GBS is preferable for predicting transfusion needs and mortality, while AIMS65 is more useful for predicting rebleeding.