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For healthcare professionals

AIMS65 score calculator (upper GI bleeding)

The AIMS65 score was built to predict death in hospital after acute upper gastrointestinal bleeding. It uses five items available in the emergency department before endoscopy: albumin, INR, mental status, systolic blood pressure and age, one point each, for a total of 0 to 5. It is written for clinicians and is not a diagnosis.

Last reviewed: By the uncovermyrisk.com editorial team Educational only, not medical advice.

Vomiting blood, black or bloody stools with dizziness or fainting, chest pain or trouble breathing: call 911 now.General safety advice (not part of the published score). The AIMS65 score is for patients already assessed for upper GI bleeding; it does not replace resuscitation or urgent care.

AIMS65 items

For an adult with acute upper gastrointestinal bleeding, using values from the first assessment. Nothing you enter leaves this page.

Altered mental status
Result appears here

What you will see

The AIMS65 score from 0 to 5 with the point for each item.

Educational only, not medical advice. Not a diagnosis. Decisions belong to the treating team.

Source

The score by Saltzman JR and colleagues, Gastrointestinal Endoscopy 2011, with items and thresholds as printed in Nik Pa NH and colleagues, Cureus 2025 (Methods), which is open access (CC BY 4.0). The tests check every item at its threshold (3.0 g/dL, 1.5, 90 mm Hg, 65 years).

Validated in

Nik Pa 2025 applied the score to 293 adults with acute upper GI bleeding in the emergency department of one tertiary hospital in Malaysia in 2022 (median age 70); AIMS65 discriminated in-hospital mortality with an area under the curve of 0.717 (95% CI 0.661 to 0.768), described as fair. We do not quote the cohort of the original 2011 paper, because its text is not open access.

Limits

The score was built for in-hospital mortality; in Nik Pa 2025 it performed less well than the Glasgow-Blatchford score for transfusion, and all scores did poorly for early endoscopy and rebleeding. We found no open-access source that prints the mortality for each score, so the tool shows the score only. Thresholds differ between papers: Nik Pa 2025 uses age 65 or older, while Barut and colleagues 2026 print age over 65 and albumin under 30 g/L; the tool follows Nik Pa 2025, which cites the original paper. Albumin is entered in g/dL.

The items

One point for each item that applies, total 0 to 5 (Nik Pa 2025):

Worked example: albumin 2.8 g/dL, INR 1.2, alert, systolic blood pressure 100 mm Hg, age 72 gives 1 + 0 + 0 + 0 + 1 = 2.

Reading the result

The score is used before endoscopy to estimate the risk of death in hospital; a higher score means a higher risk (Saltzman 2011) (Nik Pa 2025). In an emergency department cohort in Malaysia, AIMS65 was the best of the three scores tested for mortality, while the Glasgow-Blatchford score was best for predicting transfusion (Nik Pa 2025). In a 2026 emergency department cohort of 209 patients, the median AIMS65 score was 1 in survivors and 2 in those who died in hospital (Barut 2026).

Related tools

For the need for treatment such as transfusion or endoscopic therapy, use the Glasgow-Blatchford score calculator. The Rockall score calculator estimates rebleeding and death and adds endoscopic findings. Other bedside scores are listed under For healthcare professionals.

Sources

  1. Saltzman JR, Tabak YP, Hyett BH, Sun X, Travis AC, Johannes RS. 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. doi:10.1016/j.gie.2011.06.024. PMID 21907980. Original AIMS65 paper (not open access; items taken from Nik Pa 2025). pubmed.ncbi.nlm.nih.gov/21907980/
  2. Nik Pa NH, Abu Bakar A, Sabardin DM, Abd Samat AH. Diagnostic performance of AIMS65, Glasgow-Blatchford, and pre-endoscopy Rockall scores in predicting clinical outcomes among upper gastrointestinal bleeding patients in the emergency department. Cureus. 2025;17:e96795. doi:10.7759/cureus.96795. PMID 41404246. Open access (CC BY 4.0). Methods (AIMS65 items, thresholds and points) and Results. pmc.ncbi.nlm.nih.gov/articles/PMC12703674/
  3. Barut E, Yasak IH, Seyhanli ES, Giden R, Barut K. Outcome-specific performance of HALP, AIMS65, Glasgow-Blatchford, and Rockall scores in emergency department patients with acute upper gastrointestinal bleeding: a retrospective cohort study. J Clin Med. 2026;15(20):8196. doi:10.3390/jcm15208196. PMID 42941708. Open access (CC BY 4.0). Methods and Table 3. pmc.ncbi.nlm.nih.gov/articles/PMC13705710/

Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-02. Spotted an error? See About.