Gastrointestinal Bleeding Risk Calculator

This calculator uses common variables to give estimates of mortality and need for intervention based on the Glasgow-Blatchford Score, the AIMS65 score and the MELD 3.0 score.

Combined AIMS65, Glasgow Blatchford Score, and MELD 3.0 Calculator

Version 2.0.0

Demographic

Age (A/M) years

Sex (G/M)

History

Hepatic disease (G)

Dialysis within the previous 7 days (M)

Syncope (G)

Cardiac failure (G)

Melena (G)

Examination

Heart rate ≥100 beats/min (G)

Systolic blood pressure (A/G) mm Hg

Altered mental status (A)

Laboratory

Haemoglobin (G) g/L

International Normalised Ratio (A/M) ratio

Sodium (M) mmol/L

Urea (G) mmol/L

Creatinine (M) μmol/L

Bilirubin (M) μmol/L

Albumin (A/M) g/L

MELD survival timeframe (M)

AIMS65

In-hospital mortality ≈ 0.3%

Glasgow Blatchford Score

Low risk (0–1): outpatient management may be appropriate

MELD 3.0

Estimated 90-day survival: 97.6%

No clinical values are intentionally saved by this control.

Equations

AIMS65

AIMS65 = (albumin <30 g/L) + (INR >1.5) + (SBP ≤90 mm Hg) + (age ≥65 years) + (altered mental status). Each true criterion contributes 1 point.

Variables: INR = International Normalised Ratio (dimensionless); SBP = Systolic blood pressure (mm Hg). Outputs: AIMS65 score (0–5); Mapped in-hospital mortality percentage.

Glasgow Blatchford Score

GBS = urea points + sex-specific haemoglobin points + systolic blood pressure points + 1 if heart rate ≥100 + 1 if melena + 2 if syncope + 2 if hepatic disease + 2 if cardiac failure.

Variables: Urea = Urea (mmol/L): 6.5–7.9 = 2; 8.0–9.9 = 3; 10.0–24.9 = 4; ≥25 = 6; Hb = Haemoglobin (g/L): Male: 120–129 = 1, 100–119 = 3, <100 = 6. Female: 100–119 = 1, <100 = 6.; SBP = Systolic blood pressure (mm Hg): 100–109 = 1; 90–99 = 2; <90 = 3. Outputs: Glasgow Blatchford Score (0–23).

MELD 3.0 — age 18 years and older

MELD 3.0 = 1.33(if female) + 4.56×ln(bilirubin) + 0.82×(137−sodium) − 0.24×(137−sodium)×ln(bilirubin) + 9.09×ln(INR) + 11.14×ln(creatinine) + 1.85×(3.5−albumin) − 1.83×(3.5−albumin)×ln(creatinine) + 6.

Variables: bilirubin = Bilirubin (mg/dL): Calculator converts from μmol/L; minimum 1 mg/dL.; creatinine = Creatinine (mg/dL): Calculator converts from μmol/L; minimum 1 mg/dL; maximum 3 mg/dL; set to 3 mg/dL with dialysis in previous 7 days.; INR = International Normalised Ratio (dimensionless): Minimum 1.; sodium = Sodium (mmol/L): Clamped to 125–137.; albumin = Albumin (g/dL): Calculator converts from g/L; clamped to 1.5–3.5 g/dL.. Outputs: MELD 3.0 score, rounded to the nearest integer.

MELD 3.0 — age 12–17 years

MELD 3.0 = 4.56×ln(bilirubin) + 0.82×(137−sodium) − 0.24×(137−sodium)×ln(bilirubin) + 9.09×ln(INR) + 11.14×ln(creatinine) + 1.85×(3.5−albumin) − 1.83×(3.5−albumin)×ln(creatinine) + 7.33.

Variables: ln = Natural logarithm (dimensionless): Uses the same laboratory bounds and conversions as the adult equation.. Outputs: MELD 3.0 score, rounded to the nearest integer.

MELD survival estimate

S(t) = 100 × [S₀(t)]^[0.17698 × (MELD − 3.56)], where S₀(t) is 0.991, 0.981, 0.971, 0.963, 0.955, or 0.946 at 15, 30, 45, 60, 75, or 90 days respectively.

Variables: t = Selected survival timeframe (days); MELD = Rounded MELD 3.0 score (points). Outputs: Estimated survival percentage at selected timeframe.