Glasgow-Blatchford bleeding score (GBS)
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The Glasgow-Blatchford bleeding score (GBS) is based on simple clinical and laboratory variables; a score of 0 identifies low-risk patients who might be suitable for outpatient management:

  • study evidence shows that GBS identifies many patients presenting to general hospitals with upper-gastrointestinal haemorrhage who can be managed safely as outpatients. This score reduces admissions for this condition, allowing more appropriate use of in-patient resources (1)
  • advantages of the GBS over the Rockall score, which assesses the risk of mortality in patients with upper GI bleeding, includes:
    • lack of subjective variables such as the severity of systemic disease
    • lack of a need for oesophagogastroduodenoscopy (OGD) to complete the score, a feature unique to the GBS

The factors used in the GBS include blood urea, haemoglobin value, systolic blood pressure and pulse rate.

  • Blood urea (mmol/L)
    • 6·5-7·9 = 2 points
    • 8·0-9·9 = 3 points
    • 10·0-25·0 = 4 points
    • >25·0 = 6 points
  • Haemoglobin for men (g/L)
    • 120-129 =1 points
    • 100-119 = 3 points
    • <100 = 6 points
  • Haemoglobin for women (g/L)
    • 100-119 =1 point
    • <100 = 6 point
  • Systolic blood pressure (mm Hg)
    • 100-109 =1point
    • 90-99 =2 point
    • <90 =3 point
  • Other markers Pulse
    • >=100/min =1 point
    • presentation with melaena = 1 point
    • presentation with syncope = 2 point
    • hepatic disease* = 2 point
    • cardiac failure** =2 point
  • * Known history, or clinical and laboratory evidence, of chronic or acute liver disease.
  • **Known history, or clinical and echocardiographic evidence, of cardiac failure

  • Low-risk criteria of GBS
    • urea <6·5 mmol/L
    • haemoglobin >=130 g/L (men) or >=120 g/L (women)
    • systolic blood pressure >=110 mm Hg
    • pulse <100 beats per min
    • absence of melaena, syncope, cardiac failure, or liver disease

In the validation group, scores of 6 or more were associated with a greater than 50% risk of needing an intervention

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