Use AIMS65 in adults presenting to hospital with suspected or confirmed acute upper GI bleeding (for example haematemesis, coffee-ground vomiting or melena) when a simple pre-endoscopic estimate of in-hospital mortality may affect triage and monitoring. It has not been validated in children or for isolated lower GI bleeding.

Study	Population/setting	Primary outcome	Key findings
Saltzman et al., 2011	Derivation and validation cohorts including more than 30,000 adults with acute upper GI bleeding across 187 US hospitals.	In-hospital mortality, length of stay and hospital cost.	Mortality increased stepwise, from about 0.3% at 0 points to about 24-25% at 5 points in the validation cohort; scores ≥2 identified patients with substantially higher mortality and resource use.
Hyett et al., 2013	278 adults admitted with upper GI bleeding to a tertiary hospital.	Inpatient mortality and a composite endpoint including mortality, rebleeding and need for intervention.	AIMS65 predicted inpatient mortality well and outperformed the Glasgow-Blatchford score for mortality, while Glasgow-Blatchford was better for predicting transfusion need.
Thandassery et al., 2015	251 patients with acute upper GI haemorrhage at a tertiary centre, scored within 12 hours of admission.	In-hospital mortality, transfusion, ICU admission, endoscopic therapy, surgery and rebleeding.	Overall mortality was about 10%; scores ≥2 were associated with higher mortality and greater use of ICU care and transfusion.

Subsequent studies and reviews support AIMS65 as a simple pre-endoscopic mortality score. It is less reliable for rebleeding or need for endoscopic therapy than some alternatives such as Glasgow-Blatchford or Rockall. Interpret cautiously in severe chronic liver disease, variceal bleeding or bleeding that begins during an existing admission.

AIMS65 Score for Upper GI Bleeding Mortality