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Glasgow-Blatchford bleeding score

Current versionGastrointestinal·10 inputs·4 references

Pre-endoscopy score (0–23) from urea, hemoglobin, systolic BP, heart rate, melena, syncope, liver disease and cardiac failure that predicts the need for transfusion, endoscopic treatment or surgery after upper GI bleeding; a score of 0–1 identifies patients who may be suitable for outpatient management..

Pogosh offers this calculator when a case matches bleeding from the bowels, peptic ulcer, gi bleed unstable. It runs only when you press Calculate.

Decision support for clinicians — review before acting.

mg/dL or mmol/L
g/dL
mmHg
/min
Runs only when you press Calculate. Values are not stored.

References

  1. Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet. 2000;356:1318-1321. PMID 11073021. PubMed 11073021
  2. Stanley AJ, Ashley D, Dalton HR, et al. Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation. Lancet. 2009;373:42-47. PMID 19091393. PubMed 19091393
  3. Stanley AJ, Laine L, Dalton HR, et al. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study. BMJ. 2017;356:i6432. PMID 28053181; PMC5217768. PubMed 28053181
  4. Orpen-Palmer J, Stanley AJ. A review of risk scores within upper gastrointestinal bleeding. J Clin Med. 2023;12:3678. PMID 37297873; PMC10253886 (Table 1). PubMed 37297873
Implementation notes

Item points follow Table 1 of Orpen-Palmer and Stanley 2023: urea 6.5–7.9 mmol/L = 2, 8.0–9.9 = 3, 10.0–24.9 = 4, 25 or more = 6; hemoglobin in men 12.0–12.9 g/dL = 1, 10.0–11.9 = 3, below 10 = 6; in women 10.0–11.9 = 1, below 10 = 6; systolic BP 100–109 = 1, 90–99 = 2, below 90 = 3; heart rate 100 or more = 1; melena 1; syncope 2; hepatic disease 2; cardiac failure 2; range 0–23. That table prints touching band ends (male hemoglobin 120–130 g/L, female 100–120 g/L, urea above 25.0 mmol/L); here each band includes its lower edge and excludes its upper edge, so a man at 13.0 g/dL and a woman at 12.0 g/dL score 0 for hemoglobin, and urea of exactly 25.0 mmol/L scores 6. BUN in mg/dL is converted to urea in mmol/L by dividing by 2.8. Score 0 outcomes (84 of 123 managed as outpatients) are from the Stanley 2009 abstract.

Related calculators

Oakland score — safe discharge after lower GI bleedingStrate rule — severe acute lower intestinal bleedingIrritable bowel syndrome — Rome IV criteria and subtype

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