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989 Clinical Tools

AGA IPMN Risk Stratification (2015)AIMS65 Score APACHE II (AP-specific application)ASGE Choledocholithiasis Risk Stratification ATLAS Score (CDI Treatment Response)Adenoma Detection Rate (ADR) Benchmark Amsterdam II Criteria (Lynch)Anorectal Manometry Interpretation (ARM)Aronchick Bowel Preparation Scale BISAP Score Barrett's Dysplasia Grading (Vienna Classification)Boston Bowel Preparation Scale (BBPS)Bristol Stool Form Scale CD Perianal Disease Activity Index (PDAI)CDI Severity Classification (IDSA/SHEA 2021)CT Severity Index (CTSI — Balthazar)Caecal Intubation Rate (CIR) Benchmark Cambridge Classification (CP — ERCP/EUS/CT)Celiac Disease Serology Interpreter Chicago Classification v4.0 (HRM)Colorectal Cancer TNM Staging (AJCC 8th Edition)Colorectal Submucosal Invasion (Haggitt / Kikuchi)Correa Cascade Staging Cotton Criteria (ERCP Complications)Crohn's Disease Activity Index (CDAI)Crohn's Disease Endoscopic Index of Severity (CDEIS)DeMeester Score (Reflux Monitoring)Distal Contractile Integral (DCI) Calculator Dukes / Modified Astler-Coller Staging (CRC)ERCP Post-Procedure Pancreatitis Risk Score ESD/EMR Curative Resection Criteria (Gastric)Eckardt Score (Achalasia)FODMAP Reintroduction Protocol Indicator Faecal Calprotectin Interpretation Faecal Incontinence Severity Index (FISI)Forrest Classification (Peptic Re-bleed Risk)Fukuoka Consensus Criteria (Pancreatic IPMN)Gastric Cancer TNM Staging (AJCC 8th)Gastric Emptying Scintigraphy Interpretation Glasgow-Blatchford Score (GBS)H. pylori Eradication Confirmation Algorithm Harmless Acute Pancreatitis Score (HAPS)Harvey-Bradshaw (HBI) to CDAI Conversion Harvey-Bradshaw Index (HBI)IBD Steroid Response Predictor (Oxford)IBS Rome IV Diagnostic Criteria IBS Symptom Severity Score (IBS-SSS)Integrated Relaxation Pressure (IRP) Interpreter JNET Classification (NBI Colonoscopy)Kudo Pit Pattern Classification Lichtiger Index (Modified Truelove & Witts)Los Angeles (LA) Classification (GORD)Lynch Syndrome Risk — Revised Bethesda Guidelines Lyon Consensus pH-Impedance Criteria (GORD)Lémann Index (Crohn's Digestive Damage)M-ANNHEIM Classification (Chronic Pancreatitis)MUST (Malnutrition Universal Screening Tool)Magnetic Resonance Index of Activity (MaRIA)Marsh Classification (Celiac Histopathology)Mayo Endoscopic Subscore (MES)Mayo Score (Ulcerative Colitis)Mirizzi Syndrome Classification (Csendes)Modified CT Severity Index (MCTSI)Montreal Classification (Crohn's Disease)Montreal Classification (Ulcerative Colitis)NICE Classification (NBI Polyp Lexicon)NOBLADS Score (Lower GI Bleeding)NRS-2002 (Nutritional Risk Screening)NSAID GI Risk Stratification (ACG/AGA)Nancy Histopathology Index (UC)Nutritional Risk Index (NRI)OLGA / OLGIM Staging (Gastric Gastritis)Oakland Score (Lower GI Bleeding)Oesophageal Cancer TNM Staging (AJCC 8th)Oxford Acute Severe Colitis Criteria (Travis)PREDICT Barrett's Risk Score Paris Classification (GI Lesion Morphology)Partial Mayo Score (UC)Prague C&M Classification (Barrett's)Ranson Criteria Robarts Histopathology Index (RHI)Rockall Score (Acute UGIB)Rutgeerts Score (Post-op Crohn's)SCCAI (Simple Clinical Colitis Activity Index)SIBO Breath Test Interpreter (Glucose/Lactulose)Serrated Lesion Classification (WHO 2019)Short Bowel Syndrome Classification (ESPEN)Siewert Classification (OGJ Tumours)Simple Endoscopic Score for Crohn's Disease (SES-CD)Strate Score (Diverticular Bleed)TPMT / NUDT15 Phenotype-to-Dose Adjustment Thiopurine Metabolite Interpreter Tokyo Guidelines 2018 (Cholangitis Severity)Tokyo Guidelines 2018 (Cholecystitis Severity)Truelove & Witts Criteria UCEIS (UC Endoscopic Index of Severity)Vienna Classification (Crohn's)Wexner (Cleveland Clinic) Constipation Score Wexner Faecal Incontinence Score (CCFIS)Zar Score (CDI Severity Predictor)

AIMS65 Score

5-variable score predicting in-hospital mortality in acute upper GI bleeding. Superior to Rockall for mortality prediction (AUC 0.77). All variables available at admission.

Select All That Apply

Guidelines & Evidence

Clinical Details

Section 1

When to Use

Initial risk stratification of patients presenting with acute upper gastrointestinal bleeding (UGIB)

To predict in-hospital mortality, length of stay, and direct medical costs

To assist as a triage tool for ICU vs. ward admission

Applicable to both variceal and non-variceal bleeding cohorts

Patient Population

Adults presenting with clinical signs of UGIB (melena, haematemesis, or coffee-ground emesis). Validated in international cohorts including thousands of patients.

When Not to Rely on it for Discharge

AIMS65 is excellent for mortality, but less sensitive than the Glasgow-Blatchford Score (GBS) for identifying patients safe for early discharge

Active haemorrhagic shock — use physiology and shock index (HR/SBP) for immediate resuscitation decisions

Lower GI bleeding — not validated for haematochezia from lower sources

Section 2

Formula & Logic

The AIMS65 Components

A (Albumin): < 3.0 g/dL (30 g/L). Correlates with chronic health and physiological reserve.

I (INR): > 1.5. Reflects potential coagulopathy or liver synthetic dysfunction.

M (Mental Status): Altered (GCS < 15 or disorientation). A strong predictor of aspiration risk and systemic compromise.

S (Systolic BP): ≤ 90 mmHg. The classical marker of haemodynamic shock.

65 (Age): > 65 years. Older age significantly increases the risk of bleeding-related complications.

In-Hospital Mortality Risk

0 Points	0.3%
1 Point	1.2%
2 Points	5.3%
3 Points	10.3%
4 Points	16.5%
5 Points	24.5%

Section 3

Pearls/Pitfalls

AIMS65 vs. Glasgow-Blatchford Score (GBS)

The GBS (0-23 points) is superior at predicting the need for intervention (transfusion, endoscopy). However, AIMS65 is more concise and arguably superior at predicting all-cause in-hospital mortality. AIMS65 variables are often available faster in many ED settings than a GBS calculation (which requires BUN).

The Low-Risk Trap

A score of 0 or 1 does NOT mean the patient is safe for outpatient management; it only means their *mortality* risk is low. GBS remains the only tool validated for safely discharging patients directly from the ED (threshold < 2).

Performance Statistics

C-index for mortality: 0.80 (compared to GBS 0.76 and Rockall 0.70)

Identifies patients needing significantly higher ICU resources when score ≥ 2

Validated in both the US and international healthcare systems

Section 4

Next Steps

Triage Guidelines

AIMS65 ≥ 2: Consider ICU admission. High risk of mortality and prolonged stay.

AIMS65 0-1: Safe for ward admission. Early endoscopy (within 24h) is still indicated.

Complementary Tools

Glasgow-Blatchford Score (GBS)

Rockall Score (Endoscopic)

Shock Index (HR/SBP)

Section 5

Evidence Appraisal

Original Derivation

A simple risk score (AIMS65) to predict in-hospital mortality, length of stay, and cost in patients with acute upper GI bleeding.

Saltzman JR et al. • Gastrointestinal Endoscopy. 2011;74(6):1215-24. Derived from 29,222 patients.

View Source

International Validation

Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study.

Stanley AJ et al. • BMJ. 2017;356:i6432. Head-to-head comparison of GBS, AIMS65, and Rockall.

View Source

Section 6

Literature

Dr. John R. Saltzman

Developed by Dr. Saltzman at Brigham and Women's Hospital. The goal was to create a score that used bedside variables and routine labs to provide a more rapid assessment than the existing Rockall or GBS scores.

Last Comprehensive Review: 2026

Related Gastroenterology Tools

Glasgow-Blatchford Score

Forrest Classification

Rockall Score

Ranson Criteria

BISAP Score

Harvey-Bradshaw Index

Crohn's Disease Activity Index

Mayo Score

Truelove & Witts Criteria

Adenoma Detection Rate

Have feedback about this calculator?Let us know.

AIMS65 Score

5-variable score predicting in-hospital mortality in acute upper GI bleeding. Superior to Rockall for mortality prediction (AUC 0.77). All variables available at admission.

Select All That Apply

Guidelines & Evidence

Clinical Details

Section 1

When to Use

Initial risk stratification of patients presenting with acute upper gastrointestinal bleeding (UGIB)

To predict in-hospital mortality, length of stay, and direct medical costs

To assist as a triage tool for ICU vs. ward admission

Applicable to both variceal and non-variceal bleeding cohorts

Patient Population

Adults presenting with clinical signs of UGIB (melena, haematemesis, or coffee-ground emesis). Validated in international cohorts including thousands of patients.

When Not to Rely on it for Discharge

AIMS65 is excellent for mortality, but less sensitive than the Glasgow-Blatchford Score (GBS) for identifying patients safe for early discharge

Active haemorrhagic shock — use physiology and shock index (HR/SBP) for immediate resuscitation decisions

Lower GI bleeding — not validated for haematochezia from lower sources

Section 2

Formula & Logic

The AIMS65 Components

A (Albumin): < 3.0 g/dL (30 g/L). Correlates with chronic health and physiological reserve.

I (INR): > 1.5. Reflects potential coagulopathy or liver synthetic dysfunction.

M (Mental Status): Altered (GCS < 15 or disorientation). A strong predictor of aspiration risk and systemic compromise.

S (Systolic BP): ≤ 90 mmHg. The classical marker of haemodynamic shock.

65 (Age): > 65 years. Older age significantly increases the risk of bleeding-related complications.

In-Hospital Mortality Risk

0 Points	0.3%
1 Point	1.2%
2 Points	5.3%
3 Points	10.3%
4 Points	16.5%
5 Points	24.5%

Section 3

Pearls/Pitfalls

AIMS65 vs. Glasgow-Blatchford Score (GBS)

The Low-Risk Trap

Performance Statistics

C-index for mortality: 0.80 (compared to GBS 0.76 and Rockall 0.70)

Identifies patients needing significantly higher ICU resources when score ≥ 2

Validated in both the US and international healthcare systems

Section 4

Next Steps

Triage Guidelines

AIMS65 ≥ 2: Consider ICU admission. High risk of mortality and prolonged stay.

AIMS65 0-1: Safe for ward admission. Early endoscopy (within 24h) is still indicated.

Complementary Tools

Glasgow-Blatchford Score (GBS)

Rockall Score (Endoscopic)

Shock Index (HR/SBP)

Section 5

Evidence Appraisal

Original Derivation

A simple risk score (AIMS65) to predict in-hospital mortality, length of stay, and cost in patients with acute upper GI bleeding.

Saltzman JR et al. • Gastrointestinal Endoscopy. 2011;74(6):1215-24. Derived from 29,222 patients.

View Source

International Validation

Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study.

Stanley AJ et al. • BMJ. 2017;356:i6432. Head-to-head comparison of GBS, AIMS65, and Rockall.

View Source

Section 6

Literature

Dr. John R. Saltzman

Last Comprehensive Review: 2026

Related Gastroenterology Tools

Glasgow-Blatchford Score

Forrest Classification

Rockall Score

Ranson Criteria

BISAP Score

Harvey-Bradshaw Index

Crohn's Disease Activity Index

Mayo Score

Truelove & Witts Criteria

Adenoma Detection Rate

Have feedback about this calculator?Let us know.