Monday, September 24, 2018

Rockall, Blatchford, and AIMS65 scoring systems

Q: Rockall, Blatchford, and AIMS65 - are the scoring system to assess the severity of

A) Pneumonia
C) Upper gastro-intestinal  (GI) bleed
D) Increase intra-cranial pressure
E) Liver failure

Answer: C

All of the said scores assess the severity of upper GI bleed. The Rockall score 1,2  can be used only when endoscopic data is available. In contrast, the Glasgow Blatchford score 3 is useful when the patient is seen for the first time clinically. The simpler version of Blatchford score is called a modified Glasgow Blatchford score 4.  AIMS65 5 is an easy mnemonic. It stands for Albumin, INR, Mental status, Systolic blood pressure and Age (older than 65 years).

All these scores are available online and have been rigorously tested. 6, 7



1. Rockall TA, Logan RF, Devlin HB, Northfield TC. Selection of patients for early discharge or outpatient care after acute upper gastrointestinal haemorrhage. National Audit of Acute Upper Gastrointestinal Haemorrhage. Lancet 1996; 347:1138. 

2. Church NI, Dallal HJ, Masson J, et al. Validity of the Rockall scoring system after endoscopic therapy for bleeding peptic ulcer: a prospective cohort study. Gastrointest Endosc 2006; 63:606.

3. Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet 2000; 356:1318. 

4. Cheng DW, Lu YW, Teller T, et al. A modified Glasgow Blatchford Score improves risk stratification in upper gastrointestinal bleed: a prospective comparison of scoring systems. Aliment Pharmacol Ther 2012; 36:782. 

5.  Hyett BH, Abougergi MS, Charpentier JP, et al. The AIMS65 score compared with the Glasgow-Blatchford score in predicting outcomes in upper GI bleeding. Gastrointest Endosc 2013; 77:551. 

6. Stanley AJ, Laine L, Dalton HR, et al. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study. BMJ 2017; 356:i6432. 

7. Tang Y, Shen J, Zhang F, et al. Scoring systems used to predict mortality in patients with acute upper gastrointestinal bleeding in the ED. Am J Emerg Med 2018; 36:27.

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