The Glasgow-Blatchford score (GBS) is a widely-used and well-validated scoring system for upper GI bleeding and the need for intervention.
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Score
The scoring system relies upon knowing the patient's urea, hemoglobin, 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 points
Hemoglobin (g/dL) - men
>13 0 points
12-13 1 points
10-12 3 points
<10 6 points
Hemoglobin (g/dL) - women
>12 0 points
10-1 1 points
<10 6 points
Systolic BP (mm Hg)
≥110 0 points
100–109 1 points
90–99 2 points
<90 3 points
Other criteria
pulse ≥100 per min 1 point
melena present 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 > 0: 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.
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