BACKGROUND AND AIMS: The American College of Gastroenterology recommends early 
risk stratification in patients presenting with upper GI bleeding (UGIB). The 
AIMS65 score is a risk stratification score previously validated to predict 
inpatient mortality. The aim of this study was to validate the AIMS65 score as a 
predictor of inpatient mortality in patients with acute UGIB and to compare it 
with established pre- and postendoscopy risk scores.
METHODS: ICD-10 (International Classification of Diseases, Tenth Revision) codes 
identified patients presenting with UGIB requiring endoscopy. All patients were 
risk stratified by using the AIMS65, Glasgow-Blatchford score (GBS), 
pre-endoscopy Rockall, and full Rockall scores. The primary outcome was 
inpatient mortality. Secondary outcomes were a composite endpoint of inpatient 
mortality, rebleeding, and endoscopic, radiologic, or surgical intervention; 
blood transfusion requirement; intensive care unit (ICU) admission; rebleeding; 
and hospital length of stay. The area under the receiver-operating 
characteristic curve (AUROC) was calculated for each score.
RESULTS: Of the 424 study patients, 18 (4.2%) died and 69 (16%) achieved the 
composite endpoint. The AIMS65 score was superior to both the GBS (AUROC, 0.80 
vs 0.76, P < .027) and the pre-endoscopy Rockall score (0.74, P = .001) and 
equivalent to the full Rockall score (0.78, P = .18) in predicting inpatient 
mortality. The AIMS65 score was superior to all other scores in predicting the 
need for ICU admission and length of hospital stay. AIMS65, GBS, and full 
Rockall scores were equivalent (AUROCs, 0.63 vs 0.62 vs 0.63, respectively) and 
superior to pre-endoscopy Rockall (AUROC, 0.55) in predicting the composite 
endpoint. GBS was superior to all other scores for predicting blood transfusion.
CONCLUSION: The AIMS65 score is a simple risk stratification score for UGIB with 
accuracy superior to that of GBS and pre-endoscopy Rockall scores in predicting 
in-hospital mortality and the need for ICU admission.