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    Patent Pending

    AIMS65 Score for Upper GI Bleeding Mortality

    Determines risk of in-hospital mortality from upper GI bleeding.
    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with acute upper GI bleeding.

    • The AIMS65 Score for Upper GI Bleeding Mortality was designed to predict mortality in adults presenting with acute upper GI bleeding.
    • Does not rely on endoscopic data and can be easily calculated in the ED.
    • Each letter of the mnemonic (including “65”) represents an equally weighted risk factor that is cumulative in predicting severity of upper GI bleeding.
    • Mortality increases with each positive risk factor.
    • Cost and length of stay (LOS) also correlate closely with higher scores.
    • Altered mental status is defined as Glasgow Coma Scale (GCS) score <14 or a physician designation of “disoriented,” “lethargy,” “stupor,” or “coma.”
    • Of the 5 components, albumin was the single most predictive factor of mortality, perhaps as a surrogate of comorbid disease.
    • The Glasgow-Blatchford Score (GBS) has demonstrated greater sensitivity and negative predictive value for low risk bleeding; therefore, a low AIMS65 score should not be used to dictate discharge (Yaka 2013).
    • A large multinational prospective trial demonstrated the GBS to be superior to the AIMS65 in predicting need for intervention (transfusion, endoscopic treatment, IR, or surgery) or rebleeding, although the AIMS65 remained a better predictor of mortality (Stanley 2017).
    • Due to its retrospective development from a large database, correlation with endoscopic outcomes, rebleeding rates, and transfusion requirements is not known.

    Point to Keep in Mind

    • Only a small fraction (1.7%) of patients in the model were cirrhotic, although the AIMS65 score remains predictive of mortality in patients with liver disease (Gaduputi 2014).
    • Simple and quick to calculate.
    • Uses information available prior to endoscopy.
    • Highly predictive of mortality, cost, and LOS.
    • Validated in a very large cohort.
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    Next Steps
    Evidence
    Creator Insights
    Dr. John Saltzman

    About the Creator

    John Saltzman, MD, is a professor of medicine at Harvard Medical School. He currently serves as the Director of Endoscopy at Brigham and Women’s Hospital. His research focuses on on ERCP and endoscopic ultrasound/FNA.

    To view Dr. John Saltzman's publications, visit PubMed

    Are you Dr. John Saltzman? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
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