Gastroenterology Book

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Glasgow-Blatchford Bleeding Score

Aka: Glasgow-Blatchford Bleeding Score, Upper GI Bleeding Score
  1. See Also
    1. Rockall Risk Score
    2. Upper Gastrointestinal Bleeding
  2. Indication
    1. Upper Gastrointestinal Bleeding risk stratification
  3. Criteria
    1. Blood Urea Nitrogen (BUN)
      1. BUN 18.2 to 22.4 mg/dl (6.5 to 8 mmol/L): Score 2
      2. BUN 22.4 to 28 mg/dl (8 to 10 mmol/L): Score 3
      3. BUN 28 to 70 mg/dl (10 to 25 mmol/L): Score 4
      4. BUN >70 mg/dl (>25 mmol/L): Score 6
    2. Hemoglobin
      1. Men
        1. Hemoglobin 12 to 13 g/dl: Score 1
        2. Hemoglobin 10 to 12 g/dl: Score 3
        3. Hemoglobin <10 g/dl: Score 6
      2. Women
        1. Hemoglobin 10 to 12 g/dl: Score 1
        2. Hemoglobin <10 g/dl: Score 6
    3. Systolic Blood Pressure (SBP)
      1. SBP 100 to 109 mmHg: Score 1
      2. SBP 90 to 99 mmHg: Score 2
      3. SBP <90 mmHg: Score 3
    4. Miscellaneous Markers
      1. Pulse >100 per minute: 1
      2. Presentation with Melena: 1
      3. Presentation with Syncope: 2
      4. Hepatic disease: 2
      5. Cardiac failure: 2
  4. Interpretation
    1. Assesses probability for intervention (Blood Transfusion, endoscopy, surgery)
    2. Score 0
      1. Low risk for intervention
      2. Reasonable to manage as outpatient
    3. Score >0
      1. Increased risk for intervention and inpatient management is recommended
      2. However most cases <5 respond without signficant intervention
    4. Score >5
      1. High risk for intervention
  5. References
    1. Blatchford (2000) Lancet 356(9238):1318-21 [PubMed]
    2. Chen (2007) Am J Emerg Med 25(7):774-9 [PubMed]
    3. Mustafa (2015) Eur J Gastroenterol Hepatol 27(5): 512-5 +PMID:25822859 [PubMed]

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