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AIMS65 Score Calculator

Answer the five AIMS65 criteria to get the score out of 5.

How it is calculated

The score is a simple count: score = A + I + M + S + 65, where each letter is 1 if that criterion is present and 0 if not. The five yes/no fields are albumin below 3.0 g/dL, INR above 1.5, altered mental status, systolic blood pressure of 90 mmHg or lower, and age 65 or older. The tool does not measure anything itself; you decide each answer from the patient's results and only the exact answer yes adds a point, so any other value counts as no. The output is the total out of 5, shown as for example 3/5. It gives only the score, with no risk band or percentage, so interpreting it is left to the clinician and the published tables.

Worked example

A patient has albumin of 2.6 g/dL (below 3.0), a normal INR, normal mental status, a systolic pressure of 85 mmHg (90 or lower) and is 71 years old. Albumin: yes, 1 point. INR: no, 0. Mental status: no, 0. Systolic pressure: yes, 1 point. Age: yes, 1 point. Total: 1 + 0 + 0 + 1 + 1 = 3/5. If the mental status had also been altered, the score would rise to 4/5. This is a worked arithmetic example, not medical advice.

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Common mistakes

  • Applying the albumin cut-off in the wrong unit. The criterion is 3.0 g/dL, which is 30 g/L, so a result reported in g/L must be converted before answering.
  • Answering the INR question for a value of exactly 1.5. The criterion is above 1.5, so 1.5 itself is a no.
  • Using diastolic or mean pressure instead of systolic. The criterion is systolic blood pressure of 90 mmHg or lower.
  • Counting 65 as below the cut-off. The age criterion is 65 or older, so a 65-year-old scores a point.
  • Reading the total as a final decision. The tool gives a count only; it does not state a mortality rate or replace clinical assessment.

Sources

About this calculator

The AIMS65 score is a validated clinical risk-stratification tool for patients presenting with acute upper gastrointestinal bleeding, published by Saltzman et al. in 2011. It assigns one point each for five simple, readily-available criteria — the mnemonic AIMS65 itself spells them out: Albumin below 3.0 g/dL, INR above 1.5, Mental status altered, Systolic blood pressure ≤ 90 mmHg, and age 65 or older.

The resulting score out of 5 correlates strongly with in-hospital mortality, need for intensive care, and length of stay — unlike some older GI-bleed scores, it doesn't require an endoscopy result, so it can be calculated the moment a patient arrives, making it a fast triage aid for emergency physicians and gastroenterologists deciding how urgently and intensively to manage a bleed.

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  • Editorial team

    Before answering each yes or no, check that your lab value is in the unit the cut-off uses. Albumin is judged at 3.0 g/dL, which equals 30 g/L, so a report in g/L needs converting first. The edges matter too: an INR of exactly 1.5 does not count, while a systolic pressure of exactly 90 does. The tool only totals the five answers, so interpretation belongs with the treating clinician. Which of the five inputs do you find easiest to get wrong?

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