Glasgow-Blatchford score

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]
6.5–8.0	2
8.0–10.0	3
10.0–25	4
> 25	6
Haemoglobin (g/dL) for men
12.0–12.9	1
10.0–11.9	3
< 10.0	6
Haemoglobin (g/dL) 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/min	1
Melaena	1
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:^{[ citation needed ]}

• 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 mmol/L
• No melena or syncope
• No past or present liver disease or heart failure

See also

• Rockall score

References

1. Blatchford, O.; Murray, W. R.; Blatchford, M. (2000). "A risk score to predict need for treatment for uppergastrointestinal haemorrhage" . Lancet. 356 (9238): 1318–1321. doi:10.1016/S0140-6736(00)02816-6. PMID   11073021. S2CID   6371737 . Retrieved 2009-02-17.
2. 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. (2009). "Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation" . Lancet. 373 (9657): 42–47. doi:10.1016/S0140-6736(08)61769-9. PMID   19091393. S2CID   1738579 . Retrieved 2009-01-24.
3. "Archived copy". Archived from the original on 2014-12-19. Retrieved 2014-12-19.