Glasgow-Blatchford score

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The Glasgow-Blatchford bleeding score (GBS) is a screening tool to assess the likelihood that a patient with an acute upper gastrointestinal bleeding (UGIB) will need to have medical intervention such as a blood transfusion or endoscopic intervention.[1] The tool may be able to identify patients who do not need to be admitted to hospital after a UGIB. Advantages of the GBS over the Rockall score, which assesses the risk of mortality in patients with UGIB, include a lack of subjective variables such as the severity of systemic diseases and the lack of a need for oesophagogastroduodenoscopy (OGD) to complete the score, a feature unique to the GBS.

In a controlled study, 16% of patients presenting with UGIB had a GBS score of "0", considered low. Among these patients there were no deaths or interventions needed and the patients were able to be effectively treated in an outpatient setting.[2][3] [4]

Criteria for Glasgow-Blatchford Score[edit]

The score is calculated using the table below:

Glasgow-Blatchford Score
Admission risk marker Score component value
Blood Urea (mmol/L)[5]
6.5-8.0 2
8.0-10.0 3
10.0-25 4
>25 6
Haemoglobin (g/L) for men
12.0-12.9 1
10.0-11.9 3
<10.0 6
Haemoglobin (g/L) for women
10.0-11.9 1
<10.0 6
Systolic blood pressure (mm Hg)
100–109 1
90–99 2
<90 3
Other markers
Pulse ≥100 (per min) 1
Presentation with melaena 1
Presentation with syncope 2
Hepatic disease 2
Cardiac failure 2

In the validation group, scores of 6 or more were associated with a greater than 50% risk of needing an intervention.

Score[edit]

Score is equal to "0" if the following are all present:

  • Hemoglobin level >12.9 g/dL (men) or >11.9 g/dL (women)
  • Blood urea nitrogen level <18.2 mg/dL

See also[edit]

References[edit]

  1. ^ "A risk score to predict need for treatment for uppergastrointestinal haemorrhage". Retrieved 2009-02-17. 
  2. ^ "Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation". Retrieved 2009-01-24. 
  3. ^ [1] Stanley AJ et al. Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: Multicentre validation and prospective evaluation. Lancet 2009 Jan 3; 373:42. Summary Retrieved from Journal Watch 1/20/09 from Journal Watch Gastroenterology January 9, 2009
  4. ^ "Glasgow-Blatchford bleeding score". Retrieved 2009-01-24. 
  5. ^ http://www.nice.org.uk/guidance/cg141/evidence/cg141-acute-upper-gi-bleeding-full-guideline2