AIMS65 Score
Enter five clinical variables to calculate the AIMS65 score and estimate in-hospital mortality risk for upper GI bleeding.
Use the AIMS65 Score
AIMS65 Criteria
Check each criterion that is present at initial assessment.
Check the criteria on the left and click Calculate Score to see the result.
AIMS65 Score
Estimated In-Hospital Mortality
From Saltzman et al. 2011 validation cohort
Criteria Present
For educational use only. This score does not replace clinical judgment. Always interpret results in the full clinical context.
AIMS65 Score Reference Table
Mortality estimates from Saltzman et al. 2011, Am J Gastroenterol
| Score | Risk Category | Est. In-Hospital Mortality | Suggested Approach |
|---|---|---|---|
| 0 | Very Low | ~0.3% | Consider early discharge or outpatient endoscopy |
| 1 | Low | ~1.2% | Inpatient observation; elective endoscopy |
| 2 | Moderate | ~5.3% | Admit; endoscopy within 24 hours |
| 3 | High | ~10.3% | Admit; consider urgent endoscopy |
| 4 | Very High | ~16.5% | ICU or HDU; urgent endoscopy |
| 5 | Critical | ~24.5% | ICU; emergent endoscopy; multidisciplinary team |
Summary
The AIMS65 score is a validated clinical prediction tool for estimating in-hospital mortality in adults presenting with acute upper gastrointestinal bleeding (UGIB). Derived and validated by Saltzman et al. (2011) from a large multicenter database, it assigns one point each for albumin < 3.0 g/dL, INR > 1.5, altered mental status, systolic blood pressure ≤ 90 mmHg, and age ≥ 65 years. Scores range from 0 to 5, with higher scores correlating with markedly increased in-hospital mortality. AIMS65 performs comparably to the Glasgow-Blatchford Score for mortality prediction and is simpler to compute at the bedside.
How it works
- Assess each of the five clinical criteria from the patient's initial presentation.
- Assign one point for each criterion that is present.
- Sum the points to obtain the AIMS65 score (0–5).
- Higher scores correspond to greater in-hospital mortality risk.
- Use the risk category and estimated mortality to guide triage and disposition decisions.
- Always interpret results alongside the full clinical picture — this score supplements, not replaces, clinical judgment.
Use cases
- Triage patients presenting to the emergency department with hematemesis or melena.
- Guide ICU versus general ward admission decisions for UGIB patients.
- Identify high-risk patients who may need urgent endoscopy within 12 hours.
- Communicate objective risk estimates during handover between ED and GI teams.
- Stratify patients in clinical research on upper GI bleeding outcomes.
- Educate medical students and residents on systematic UGIB risk assessment.