AIMS65, A RISK STRATIFICATION SCORE FOR UPPER GASTROINTESTINAL BLEEDING, ACCURATELY PREDICTS MORTALITY IN PATIENTS PRESENTING WITH ACUTE VARICEAL BLEEDING: A PROSPECTIVE MULTICENTRE STUDY.

Introduction: Acute variceal bleeding (AVB)is a common medical emergency in patients with portal hypertension and carries a published inpatient mortality risk of 11-43%. It remains unclear whether measures of liver disease severity (liver risk)or upper gastrointestinal bleeding (UGIB)risk stratification scores offer the best predictive power in patients with AVB. AIMS65 is a risk stratification score validated to predict inpatient mortality. The AIMS65 score assigns 1 point for each of the following: albumin level < 30g/L, INR > 1.5, altered mental status, systolic blood pressure < 90mmHg and age > 65 years. Objective(s): To prospectively validate AIMS65 as a predictor of inpatient and 6-week mortality in patients with AVB and to compare AIMS65 with established liver and UGIB risk scores as predictors of inpatient mortality and re-bleeding. Method(s): Patients presenting with AVB to 2 Australian tertiary hospitals were prospectively collected for 24 months from 2016 to 2018 using a purpose-built smartphone app. Patients were risk stratified using AIMS65, Rockall, pre-endoscopy Rockall (pre-Rockall), Child-Pugh (CP), Model for Endstage Liver Disease (MELD)and United Kingdom MELD (UKELD)scores. The primary outcome was inpatient mortality. Secondary outcomes were: 6-week mortality, rebleeding, intensive care unit (ICU)admission and length of stay (LOS). The area under the receiver-operating characteristic curve (AUROC)was calculated for each score. Result(s): 67 patients were included. Median age was 56 years (IQR 49-68), 68% were male and median MELD and CP scores were 18 (IQR 13-22)and 8 (IQR 7-10)respectively. 60 (88%)patients had cirrhosis with alcohol (60%)and hepatitis C (30%)the most common aetiologies; 11 (16%)had hepatocellular carcinoma. Median LOS was 6 days and 34% patients were managed in the ICU. Inpatient and 6-week mortality was 14.9% and 22.4% respectively. 18% patients experienced rebleeding during initial hospitalisation. 66% patients received a bloo