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AIMS65 Score for Upper GI Bleeding

AIMS65 predicts in-hospital mortality in upper GI bleeding with one point each for albumin <3.0 g/dL, INR >1.5, altered mental status, systolic BP ≤90 mmHg and age ≥65. Mortality rises from 0.3% at 0 to 31.8% at 5; a score ≥2 marks high risk.

Serum albumin (g/dL or g/L)
INR
Altered mental status (GCS <14, disorientation, lethargy) (yes/no, +1)
Systolic blood pressure (mmHg or kPa)
Age (years)

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Interpretation

Result	Meaning
0	In-hospital mortality 0.3%
0–1	Low risk
≥ 2	High risk
5	In-hospital mortality 31.8%

Formula

One point each: Albumin <3.0 g/dL (<30 g/L) · INR >1.5 · altered Mental status · Systolic BP ≤90 mmHg · age ≥65

Clinical pearls

Predicts mortality, not need for intervention; it is weaker than Glasgow-Blatchford at identifying patients safe for discharge.
Derived from US administrative data, so rebleeding was not captured.

Examples

aims65 alb 2.6 inr 1.7 confused sbp 85 age 78 AIMS65 for a 50 year old with albumin 3.8, INR 1.1, alert, BP 130 systolic aims 65 albumin 28 g/L inr 1.4 sbp 100 72 yo alert

FAQ

What does AIMS65 stand for?

Albumin <3.0 g/dL, INR >1.5, altered Mental status, Systolic BP ≤90 mmHg, and age 65 or older.

Evidence

Saltzman JR et al. A simple risk score accurately predicts in-hospital mortality, length of stay, and cost in acute upper GI bleeding. Gastrointest Endosc 2011;74:1215–24.

Hepatology & GI · Reviewed 2026-10-14 · Methodology