Comparison of the Glasgow-Blatchford Risk Score vs AIMS65 Score in Patients on Coumadin and Anti-platelet Therapy or Dual Anti-platelet Therapy: 1130

Introduction: Upper gastrointestinal bleeding (UGIB) risk stratification using validated prognostic scales can be used to provide appropriate management and give the clinician an indication of morbidity and mortality. The Glasgow-Blatchford Risk Score (GBRS) was developed to predict medical intervention needed, which included transfusion, endoscopy, or surgery. A higher GBS score also correlated with a higher likelihood of needing intervention. The AIMS65 Score has been validated to predict inpatient mortality in patients with UGIB. This particular study draws on these two prognostic tools and assesses their ability to risk stratify patients with UGIB on dual anti-platelet therapy (APA) or anti-platelet therapy (APA) with coumadin. Methods: This study was a retrospective study of 114 patients admitted to a tertiary care center with a primary diagnosis of UGIB from November 2013 to September 2015. Selected patients were on 2 APAs or APA and Coumadin at time of admission. The AIMS65 score was compared to the GBRS in predicting upper GI bleeding outcomes as it relates to 30 day readmission rates, mortality, re-bleeding, and intensive care unit (ICU) transfer amongst those on dual APAs or APA(s) with coumadin. The scores were compared using the area under the receiver operator curve (AUROC) with Statistical Analysis System soft ware. Results: The GBRS correlated with a higher likelihood of ICU admission than the AIMS65 score. The two scores did not differ statistically between 30 day readmission rates, mortality, or re-bleeding. Conclusion: Patients presenting with UGIB, currently on dual APA regimen or APA with coumadin should be risk stratified with the GBRS in order to assess their need for ICU admission. Application of these findings may improve utilization of resources and facilitate clinical decision making in this subset of high risk patients.