Glasgow-Blatchford score explained

Glasgow-Blatchford score
Purpose:need for blood transfusion due to GI bleeding

The Glasgow-Blatchford bleeding score (GBS) is a screening tool to assess the likelihood that a person 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 people 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 death in 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.

It was developed in 2000 by Oliver Blatchford (born 24 August 1954) at the Glasgow Royal Infirmary.

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

Criteria

The score is calculated using the table below:

Admission
risk marker
Score component
value
Blood urea (mmol/L)[3]
6.5–8.02
8.0–10.03
10.0–254
> 256
Haemoglobin (g/dL) for men
12.0–12.91
10.0–11.93
< 10.06
Haemoglobin (g/dL) for women
10.0–11.91
< 10.06
Systolic blood pressure (mm Hg)
100–1091
90–992
< 903
Other markers
Pulse ≥ 100/min1
Melaena1
Syncope2
Hepatic disease2
Cardiac failure2

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

Score

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

See also

Notes and References

  1. A risk score to predict need for treatment for uppergastrointestinal haemorrhage. 2000 . 11073021 . 2009-02-17. Blatchford . O. . Murray . W. R. . Blatchford . M. . Lancet . 356 . 9238 . 1318–1321 . 10.1016/S0140-6736(00)02816-6 . 6371737 .
  2. Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation . 2009 . 19091393 . 2009-01-24. Stanley . A. J. . Ashley . D. . Dalton . H. R. . Mowat . C. . Gaya . D. R. . Thompson . E. . Warshow . U. . Groome . M. . Cahill . A. . Benson . G. . Blatchford . O. . Murray . W. . Lancet . 373 . 9657 . 42–47 . 10.1016/S0140-6736(08)61769-9 . 1738579 .
  3. Web site: Archived copy . 2014-12-19 . https://web.archive.org/web/20141219161410/http://www.nice.org.uk/guidance/cg141/evidence/cg141-acute-upper-gi-bleeding-full-guideline2 . 2014-12-19 . dead .