Prognostic Value of AIMS65 Score to Predict Outcome in Patients With Acute Upper Gastrointestinal Bleeding

Gastrointestinal (GI) bleeding is one of the most important disease presentations in the emergency department. The course of the disease ranges from a self-limiting process to a life-threatening condition that requires emergency intervention. Evaluation of severity and the need for endoscopic hemostasis are matters of immediate decision. several prognostic scoring systems have been used to predict outcomes of upper GI bleeding ,such as the Rockall score, Glasgow-Blatchford score (GBS), and the AIMS65 score, among which AIMS65 is relatively easy to remember and simple to calculate by using parameters routinely available in the ED and importantly does not require endoscopic variables for calculation..

The AIMS65 score consists of five factors:

(i)albumin (1 point for value less than 3.0 g/dL (30 g/L)). (ii)INR (1 point for value greater than 1.5) . (iii)altered mental status (1 point given if Glasgow coma score was less than 14 or if disorientation, lethargy, stupor, or coma was seen) (iv)systolic blood pressure (1 point for value less than 90 mmHg). (v)age (1 point for value greater than 65 years). AIMS65 score >1: high risk patients. AIMS65 score >2: consider ICU management and an urgent endoscopy following adequate volume resuscitation, while AIMS65 score of 0 can be considered for outpatient management.

AIMS65 score is a simple non-endoscopic risk score that can be applied in patients of acute upper gastrointestinal bleeding to risk stratify and to predict in-patient mortality, the need for blood transfusion, endoscopic therapy or ICU admission.

In a comparative study of AIMS65 score and GBS ,they found that the AIMS65 score was superior in predicting inpatient mortality from UGIB, while the GBS was superior for predicting the need for blood transfusion. Both scores were similar in predicting the composite clinical endpoint .