Glasgow-Blatchford score

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

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

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

• Hemoglobin level >12.9 g/dL (men) or >11.9 g/dL (women)
• Systolic blood pressure >109 mm Hg
• Pulse <100/minute
• Blood urea nitrogen level <6.5 mg/dL
• No melena or syncope
• No past or present liver disease or heart failure

See also

• Rockall score

References

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. 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