How it's calculated
One point each for five criteria — Albumin <3.0 g/dL, INR >1.5, altered Mental status, Systolic BP ≤90 mmHg, and age >65 — for a total of 0-5.
Interpretation
| Score | Mortality risk |
|---|---|
| 0-1 | Lower |
| 2 | Moderate |
| 3-5 | High |
Clinical use
- Used alongside the Glasgow-Blatchford score (pre-endoscopy risk of needing intervention) and the Rockall score (post-endoscopy rebleeding/mortality risk) for a fuller picture of upper GI bleed severity.
- AIMS65 was specifically derived and validated to predict inpatient mortality, rather than need for transfusion or endoscopic intervention.
- A higher score should prompt consideration of a higher level of care (e.g. ICU/HDU) and expedited endoscopy.
Frequently asked questions
What does AIMS65 stand for?
Albumin <3.0, INR >1.5, altered Mental status, Systolic BP ≤90 mmHg, age >65 — one point each, for a score out of 5.
How is AIMS65 different from the Glasgow-Blatchford score?
Glasgow-Blatchford predicts the need for transfusion, endoscopic intervention, or death, and is calculated before endoscopy using only clinical and basic lab data; AIMS65 was derived specifically to predict inpatient mortality and uses a different, smaller set of variables.
Does a low AIMS65 score mean endoscopy isn't needed?
No — AIMS65 stratifies mortality risk but doesn't replace the clinical decision to perform endoscopy, which is guided by the overall presentation and other risk scores.
References
- Saltzman JR, et al. A simple risk score accurately predicts in-hospital mortality, length of stay, and cost in acute upper GI bleeding. Gastrointest Endosc. 2011;74(6):1215-1224.