AIMS65 Score for Upper GI Bleeding Mortality
Determines risk of in-hospital mortality from upper GI bleeding
Jennifer Glen
Provided by
EVAL FoundationInstructions
- Designed to predict mortality in adults presenting with acute upper GI bleeding.
- Does not rely on endoscopic data
Altered mental status is defined as Glasgow Coma Scale (GCS) score <14 or a physician designation of “disoriented,” “lethargy,” “stupor,” or “coma.”
Usage
Summary
The AIMS65 score was designed to predict mortality in adults presenting with acute upper GI bleeding (Saltzman, 2011).
- Simple calculation
- Does not rely on endoscopic data
- Highly predictive of mortality, cost and length of stay
Summary
AIMS65 Score
- Designed to predict mortality in adults presenting with acute upper GI bleeding.
- Does not rely on endoscopic data
Criteria
There are 5 equally weighted risk factors that cumulatively predict severity of upper GI bleeding.
- Albumin <3 g/dL (30 g/L)
- INR > 1.5
- Alteration in mental status
- sBP ≤ 90 mm Hg
- Age ≥ 65 years
Rules
| AIMS65 Score | In-hospital Mortality Rate |
| 0 | 0.3% |
| 1 | 1.2% |
| 2 | 5.3% |
| 3 | 10.3% |
| 4 | 16.5% |
| 5 | 24.5% |
Notes
- Validations studies demonstrate that AIMS65 is superior to the Glasgow-Blatchford Score (GBS) and the Pre-endoscopy Rockall Score for predicting in-hospital mortality, ICU admission, and Length of Stay (Robertson, 2016).
- For low risk bleeding, a low AIMS65 score should not be used to dictate discharge (Yaka, 2015). The GBS has shown greater sensitivity and negative predictive value for low bleed risk.
- GBS may be superior to the AIMS65 in predicting need for intervention or rebleeding (Stanley, 2017)
- Albumin is the single most predictive factor of mortality of the 5 criteria.
All questions & possible results
CriteriaTitle not visible
Albumin <3 g/dL (30 g/L)
Select one option:
- Yes
- No
INR >1.5
Select one option:
- Yes
- No
Alteration in mental status
Altered mental status is defined as Glasgow Coma Scale (GCS) score <14 or a physician designation of “disoriented,” “lethargy,” “stupor,” or “coma.”
Select one option:
- Yes
- No
sBP ≤90 mm Hg
Select one option:
- Yes
- No
Age ≥65 years
Select one option:
- Yes
- No
Possible results
AIMS65 Score: 5 points
24.5% In-hospital Mortality Rate
Considerations:
- Validation studies demonstrate that AIMS65 is superior to the Glasgow-Blatchford Score (GBS) and the Pre-endoscopy Rockall Score for predicting in-hospital mortality, ICU admission, and Length of Stay (Robertson, 2016).
- GBS may be superior to the AIMS65 in predicting need for intervention or rebleeding (Stanley, 2017)
- For low risk bleeding, a low AIMS65 score should not be used to dictate discharge (Yaka, 2015). The GBS has shown greater sensitivity and negative predictive value for low bleed risk.
- Albumin is the single most predictive factor of mortality of the 5 criteria.
AIMS65 Score: 2 points
5.3% In-hospital Mortality Rate
Considerations:
- Validation studies demonstrate that AIMS65 is superior to the Glasgow-Blatchford Score (GBS) and the Pre-endoscopy Rockall Score for predicting in-hospital mortality, ICU admission, and Length of Stay (Robertson, 2016).
- GBS may be superior to the AIMS65 in predicting need for intervention or rebleeding (Stanley, 2017)
- For low risk bleeding, a low AIMS65 score should not be used to dictate discharge (Yaka, 2015). The GBS has shown greater sensitivity and negative predictive value for low bleed risk.
- Albumin is the single most predictive factor of mortality of the 5 criteria.
AIMS65 Score: 1 points
1.2% In-hospital Mortality Rate
Considerations:
- Validation studies demonstrate that AIMS65 is superior to the Glasgow-Blatchford Score (GBS) and the Pre-endoscopy Rockall Score for predicting in-hospital mortality, ICU admission, and Length of Stay (Robertson, 2016).
- GBS may be superior to the AIMS65 in predicting need for intervention or rebleeding (Stanley, 2017)
- For low risk bleeding, a low AIMS65 score should not be used to dictate discharge (Yaka, 2015). The GBS has shown greater sensitivity and negative predictive value for low bleed risk.
- Albumin is the single most predictive factor of mortality of the 5 criteria.
AIMS65 Score: 4 points
16.5% In-hospital Mortality Rate
Considerations:
- Validation studies demonstrate that AIMS65 is superior to the Glasgow-Blatchford Score (GBS) and the Pre-endoscopy Rockall Score for predicting in-hospital mortality, ICU admission, and Length of Stay (Robertson, 2016).
- GBS may be superior to the AIMS65 in predicting need for intervention or rebleeding (Stanley, 2017)
- For low risk bleeding, a low AIMS65 score should not be used to dictate discharge (Yaka, 2015). The GBS has shown greater sensitivity and negative predictive value for low bleed risk.
- Albumin is the single most predictive factor of mortality of the 5 criteria.
AIMS65 Score: 3 points
10.3% In-hospital Mortality Rate
Considerations:
- Validation studies demonstrate that AIMS65 is superior to the Glasgow-Blatchford Score (GBS) and the Pre-endoscopy Rockall Score for predicting in-hospital mortality, ICU admission, and Length of Stay (Robertson, 2016).
- GBS may be superior to the AIMS65 in predicting need for intervention or rebleeding (Stanley, 2017)
- For low risk bleeding, a low AIMS65 score should not be used to dictate discharge (Yaka, 2015). The GBS has shown greater sensitivity and negative predictive value for low bleed risk.
- Albumin is the single most predictive factor of mortality of the 5 criteria.
AIMS65 Score: 0 points
0.3% In-hospital Mortality Rate
Considerations:
- Validation studies demonstrate that AIMS65 is superior to the Glasgow-Blatchford Score (GBS) and the Pre-endoscopy Rockall Score for predicting in-hospital mortality, ICU admission, and Length of Stay (Robertson, 2016).
- GBS may be superior to the AIMS65 in predicting need for intervention or rebleeding (Stanley, 2017)
- For low risk bleeding, a low AIMS65 score should not be used to dictate discharge (Yaka, 2015). The GBS has shown greater sensitivity and negative predictive value for low bleed risk.
Literature
- International Gastrointestinal Bleeding Consortium. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study. BMJ. 2017 Jan 4;356:i6432. — Stanley AJ, Laine L, Dalton HR, Ngu JH, Schultz M, Abazi R, Zakko L, Thornton S, Wilkinson K, Khor CJ, Murray IA, Laursen SB;
- Risk stratification in acute upper GI bleeding: comparison of the AIMS65 score with the Glasgow-Blatchford and Rockall scoring systems. Gastrointest Endosc. 2016 Jun;83(6):1151-60. — Robertson M, Majumdar A, Boyapati R, Chung W, Worland T, Terbah R, Wei J, Lontos S, Angus P, Vaughan R.
- Comparison of the Glasgow-Blatchford and AIMS65 scoring systems for risk stratification in upper gastrointestinal bleeding in the emergency department. Acad Emerg Med. 2015 Jan;22(1):22-30. — Yaka E, Yılmaz S, Doğan NÖ, Pekdemir M.
- A simple risk score accurately predicts in-hospital mortality, length of stay, and cost in acute upper GI bleeding. Gastrointest Endosc. 2011 Dec;74(6):1215-24. — Saltzman JR, Tabak YP, Hyett BH, Sun X, Travis AC, Johannes RS.
- Clinical Application of AIMS65 Scores to Predict Outcomes in Patients with Upper Gastrointestinal Hemorrhage. Clin Endosc. 2015 Sep;48(5):380-4. — Thandassery RB, Sharma M, John AK, Al-Ejji KM, Wani H, Sultan K, Al-Mohannadi M, Yakoob R, Derbala M, Al-Dweik N, Butt MT, Al-Kaabi SR.
- A Risk Score to Predict Need for Treatment for Upper gastrointestinal haemorrhage. The Lancet. 2000 Oct;356(9238):1318-1321. — Blatchford O, Murray WR, Blatchford M.
