Glasgow-Blatchford Score (upper GI bleeding severity)
Severity stratification for upper GI bleeding to guide admission and timing of endoscopy.
About this calculator
Glasgow-Blatchford Score (GBS) assesses upper gastrointestinal bleeding (UGIB) severity before endoscopy. Developed by Blatchford et al. (Lancet, 2000) in 1748 patients. Aim: identify low-risk patients dischargeable without urgent endoscopy. Eight parameters: blood urea, hemoglobin, systolic BP, heart rate, melena, syncope, liver disease, heart failure. Maximum 23. Interpretation. 0 – very low risk, outpatient workup, endoscopy within 24-48 hours. 1-3 – low, admission for observation. 4-7 – moderate, endoscopy within 24 hours. >=8 – high, urgent endoscopy within 12 hours, may need transfusion, ICU. Clinical use. ESGE 2021 and AGA 2021 recommend GBS as the primary prehospital and pre-endoscopic tool. Patients with GBS=0 (about 15-20% of UGIB) can be managed safely as outpatients – ESGE confirms this rule. GBS outperforms Rockall in discriminating low vs high risk. Limitations. Does not explicitly capture anticoagulants and antiplatelets – on warfarin or DOAC, risk is higher than GBS predicts. In older patients with chronic anemia hemoglobin may falsely raise the score. After endoscopy, mortality prognosis uses the Forrest classification for ulcer bleeding and Rockall.
Source
Formula version: blatchford-2000-nice-2012-v1