Glasgow-Blatchford score

The Glasgow-Blatchford 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 points

• 22.4-28 3 points

• 28-70 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

• 10-1                    1                   1 points

• <10 6 points

Systolic BP (mm Hg)

• ≥110                   0                  0 points

• 100–109 1 points

• 90–99 2 points

• <90 3 points

Other criteria

• pulse ≥100 per min            1           1 point

• melaena present                1               1 point

• presentation with syncope 2 points

• liver disease history 2 points

• cardiac failure present 2 points

Evaluation

• score may be anything from 0 to 23

• score is 0: low risk - may be discharged home

• score &gt;0; 0: high high risk for active intervention

  • transfusion, endoscopy, or surgery

  • for non-variceal bleeds, patients with a score of 2 or less can be safely discharged with early outpatient investigation⁴

History and etymology

The Glasgow-Blatchford 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.

See also

• Rockall score

• AIMS65 score

• Progetto Nazionale Emorragia Digestiva score