AIMS65 Score for Upper GI Bleeding Mortality
Determines risk of in-hospital mortality from upper GI bleeding
Créateur
Dr. John Saltzman, MDInstructions
Designed to predict mortality in adults presenting with acute upper GI bleeding.
Does not rely on endoscopic data
Introduction
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
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
Scoring
AIMS65 Score | In-hospital Mortality Rate |
0 | 0.3% |
1 | 1.2% |
2 | 5.3% |
3 | 10.3% |
4 | 16.5% |
5 | 24.5% |
Considerations
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.
Toutes les questions et résultats possibles
CriteriaTitre non 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
Résultats possibles
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.
Citation
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 Dec;74(6):1215-24.
Bibliographie
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.
https://pubmed.ncbi.nlm.nih.gov/28053181/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.
https://pubmed.ncbi.nlm.nih.gov/26515955/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.
https://pubmed.ncbi.nlm.nih.gov/25556538/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.
https://pubmed.ncbi.nlm.nih.gov/21907980/Clinical Application of AIMS65 Scores to Predict Outcomes in Patients with Upper Gastrointestinal Hemorrhage. Clin Endosc. 2015 Sep;48(5):380-4.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604275/A Risk Score to Predict Need for Treatment for Upper gastrointestinal haemorrhage. The Lancet. 2000 Oct;356(9238):1318-1321.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(00)02816-6/abstract
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