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:
| 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
References
- ↑ "A risk score to predict need for treatment for uppergastrointestinal haemorrhage". Retrieved 2009-02-17.
- ↑ "Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation". Retrieved 2009-01-24.
- ↑ 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
- ↑ "Glasgow-Blatchford bleeding score". Retrieved 2009-01-24.
- ↑ http://www.nice.org.uk/guidance/cg141/evidence/cg141-acute-upper-gi-bleeding-full-guideline2