Glasgow-Blatchford score

Changed by Daniel J Bell, 5 May 2022

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Disclosures - updated 3 May 2022: Nothing to disclose

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Glasgow-Blatchford ~~Score~~score

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The Glasgow-Blatchford ~~Score~~score (GBS) is a widely-used and well-validated scoring system for upper GI bleeding and the need for intervention.

Score

The scoring system relies upon knowing the patient's urea, haemoglobin, systolic blood pressure, and several other criteria. Each criterion is scored, and the points added together to give a single overall score.

Urea (mg/dL)

<18.2 0 points
18.2-22.3 +2 2 points
22.4-28 +3 3 points
28-70 +4 4 points
>70 +6 6 points

Haemoglobin (g/dL) - men

>13 0 0 points
12-13 +1 1 points
10-12 +3 3 points
<10 +6 6 points

Haemoglobin (g/dL) - women

>12 0 points
10~~-12 +1~~-1 1 points
<10 +6 6 points

Systolic BP (mm Hg)

~~≥1100~~≥110 0 points
100–109 +1 1 points
90–99 +2 2 points
<90 +3 3 points

Other criteria

pulse ≥100 per min +1 1 point
melaena present +1 1 point
presentation with syncope +2 2 points
liver disease history +2 2 points
cardiac failure present +2 2 points

Evaluation

score may be anything from 0 to 23

score is 0: low risk - may be discharged home
score >0: high risk for active intervention
- transfusion, endoscopy, or surgery

History and etymology

The Glasgow-Blatchford ~~Bleeding Score~~score was devised by a (now retired) Scottish public health specialist Oliver Blatchford (fl. 2022) et al, from studying a large population of patients in the city of Glasgow in 1997 ¹.

-<p>The <strong>Glasgow-Blatchford Score</strong> (<strong>GBS</strong>) is a well-validated scoring system for <a title="Upper GI bleeding" href="/articles/upper-gastrointestinal-bleeding">upper GI bleeding</a> and the need for intervention.</p><h4>Score</h4><p>The scoring system relies upon knowing the patient's urea, <a title="Haemoglobin" href="/articles/haemoglobin">haemoglobin</a>, <a title="Systolic blood pressure" href="/articles/blood-pressure">systolic blood pressure</a>, and several other criteria.</p><p><strong>Urea (mg/dL)</strong></p><ul>
~~-<li><18.2 0</li>~~
~~-<li>18.2-22.3 +2</li>~~
~~-<li>22.4-28 +3</li>~~
~~-<li>28-70 +4</li>~~
~~-<li>>70 +6</li>~~
+<p>The <strong>Glasgow-Blatchford score</strong> (<strong>GBS</strong>) is a widely-used and well-validated scoring system for <a href="/articles/upper-gastrointestinal-bleeding">upper GI bleeding</a> and the need for intervention.</p><h4>Score</h4><p>The scoring system relies upon knowing the patient's <a href="/articles/urea">urea</a>, <a href="/articles/haemoglobin">haemoglobin</a>, <a href="/articles/blood-pressure">systolic blood pressure</a>, and several other criteria. Each criterion is scored, and the points added together to give a single overall score.</p><p><strong>Urea (mg/dL)</strong></p><ul>
+<li><18.2 0 points</li>
+<li>18.2-22.3 2 points</li>
+<li>22.4-28 3 points</li>
+<li>28-70 4 points</li>
+<li>>70 6 points</li>
~~-<li>>13 0</li>~~
~~-<li>12-13 +1</li>~~
~~-<li>10-12 +3</li>~~
~~-<li><10 +6</li>~~
+<li>>13 0 points</li>
+<li>12-13 1 points</li>
+<li>10-12 3 points</li>
+<li><10 6 points</li>
~~-<li>>12 0</li>~~
~~-<li>10-12 +1</li>~~
~~-<li><10 +6</li>~~
+<li>>12 0 points</li>
+<li>10-1 1 points</li>
+<li><10 6 points</li>
~~-<li>≥1100</li>~~
~~-<li>100–109 +1</li>~~
~~-<li>90–99 +2</li>~~
~~-<li><90 +3</li>~~
+<li>≥110 0 points</li>
+<li>100–109 1 points</li>
+<li>90–99 2 points</li>
+<li><90 3 points</li>
~~-<a title="pulse rate" href="/articles/pulse-rate">pulse</a> ≥100 per min +1</li>~~
+<a href="/articles/pulse-rate">pulse</a> ≥100 per min 1 point</li>
~~-<a title="melaena" href="/articles/melaena">melaena</a> present +1</li>~~
~~-<li>presentation with <a title="syncope" href="/articles/syncope">syncope</a> +2</li>~~
~~-<li>liver disease history +2</li>~~
+<a href="/articles/melaena">melaena</a> present 1 point</li>
+<li>presentation with <a href="/articles/syncope">syncope</a> 2 points</li>
+<li>liver disease history 2 points</li>
~~-<a title="Cardiac failure" href="/articles/heart-failure-summary">cardiac failure</a> present +2</li>~~
+<a href="/articles/heart-failure-summary">cardiac failure</a> present 2 points</li>
+<li>score may be anything from 0 to 23</li>
-</ul><h4>History and etymology</h4><p>The Glasgow-Blatchford Bleeding Score was devised by a (now retired) Scottish public health specialist <strong>Oliver Blatchford</strong> (<a title="Fl. (term)" href="/articles/biographical-article-structure">fl.</a> 2022) et al, from studying a large population of patients in the city of Glasgow in 1997 <sup>1</sup>.</p>
+</ul><h4>History and etymology</h4><p>The Glasgow-Blatchford score was devised by a (now retired) Scottish public health specialist <strong>Oliver Blatchford</strong> (<a href="/articles/biographical-article-structure">fl.</a> 2022) et al, from studying a large population of patients in the city of Glasgow in 1997 <sup>1</sup>.</p><h4>See also</h4><ul>
+<li><a href="/articles/rockall-score">Rockall score</a></li>
+<li><a href="/articles/aims65-score">AIMS65 score</a></li>
+<li><a href="/articles/progetto-nazionale-emorragia-digestiva-score">Progetto Nazionale Emorragia Digestiva score</a></li>
+</ul>

References changed:

1. Blatchford O, Murray W, Blatchford M. A Risk Score to Predict Need for Treatment for Upper-Gastrointestinal Haemorrhage. Lancet. 2000;356(9238):1318-21. <a href="https://doi.org/10.1016/S0140-6736(00)02816-6">doi:10.1016/S0140-6736(00)02816-6</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/11073021">Pubmed</a>
2. Laursen S, Dalton H, Murray I et al. Performance of New Thresholds of the Glasgow Blatchford Score in Managing Patients with Upper Gastrointestinal Bleeding. Clin Gastroenterol Hepatol. 2015;13(1):115-21.e2. <a href="https://doi.org/10.1016/j.cgh.2014.07.023">doi:10.1016/j.cgh.2014.07.023</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/25058843">Pubmed</a>
2. Laursen S, Dalton H, Murray I et al. Performance of New Thresholds of the Glasgow Blatchford Score in Managing Patients with Upper Gastrointestinal Bleeding. Clin Gastroenterol Hepatol. 2015;13(1):115-21.e2. <a href="https://doi.org/10.1016/j.cgh.2014.07.023">doi:10.1016/j.cgh.2014.07.023</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/25058843">Pubmed</a>
3. Barkun A, Almadi M, Kuipers E et al. Management of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group. Ann Intern Med. 2019;171(11):805-22. <a href="https://doi.org/10.7326/M19-1795">doi:10.7326/M19-1795</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/31634917">Pubmed</a>
2. Franco M, Jang S, Martins B et al. Risk Stratification in Cancer Patients with Acute Upper Gastrointestinal Bleeding: Comparison of Glasgow-Blatchford, Rockall and AIMS65, and Development of a New Scoring System. Clin Endosc. 2022;55(2):240-7. <a href="https://doi.org/10.5946/ce.2021.115">doi:10.5946/ce.2021.115</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/35052025">Pubmed</a>

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