Glasgow-Blatchford Score Calculator
Pre-endoscopy risk stratification for upper gastrointestinal bleeding. Identifies patients at very low risk who may not require admission or intervention.
Clinical Findings
Scoring Criteria
| Parameter | Value | Points |
|---|---|---|
| BUN (mg/dL) | < 18.2 | 0 |
| 18.2 - 22.3 | 2 | |
| 22.4 - 27.9 | 3 | |
| 28 - 69.9 | 4 | |
| ≥ 70 | 6 | |
| Hemoglobin - Men (g/dL) | ≥ 13 | 0 |
| 12 - 12.9 | 1 | |
| 10 - 11.9 | 3 | |
| Hemoglobin - Women (g/dL) | ≥ 12 | 0 |
| 10 - 11.9 | 1 | |
| Hemoglobin - Both (g/dL) | < 10 | 6 |
| Systolic BP (mmHg) | ≥ 110 | 0 |
| 100 - 109 | 1 | |
| 90 - 99 | 2 | |
| < 90 | 3 | |
| Heart Rate (bpm) | ≥ 100 | 1 |
| Melena | Present | 1 |
| Syncope | Present | 2 |
| Hepatic Disease | Present | 2 |
| Heart Failure | Present | 2 |
Note: Score of 0 identifies patients at very low risk who may be suitable for outpatient management. Studies show 99% of patients with GBS = 0 do not require intervention.
About the Glasgow-Blatchford Score
The Glasgow-Blatchford Score (GBS) is a validated clinical risk stratification tool used to predict the need for intervention (endoscopic therapy, blood transfusion, or surgery) in patients presenting with upper gastrointestinal bleeding.
Clinical Applications
- Identifies low-risk patients who may not require hospital admission
- Guides timing of endoscopy (urgent vs. elective)
- Predicts need for blood transfusion or endoscopic intervention
- Supports safe early discharge decisions
- Resource allocation and triage in emergency settings
Advantages
- Can be calculated at presentation using readily available data
- No endoscopic findings required (pre-endoscopy tool)
- High sensitivity for identifying low-risk patients
- Validated across multiple populations and settings
- Superior to Rockall score for predicting need for intervention
Clinical Evidence
Multiple studies have validated that patients with a GBS of 0 have very low rates of rebleeding, mortality, and need for intervention. These patients can often be safely managed as outpatients with appropriate follow-up arrangements.
Frequently Asked Questions
What does a Glasgow-Blatchford Score of 0 mean?
A score of 0 indicates very low risk. Studies show that approximately 99% of patients with GBS = 0 do not require any intervention (transfusion, endoscopy, or surgery) and can potentially be managed as outpatients with appropriate follow-up.
How does GBS differ from the Rockall Score?
The Glasgow-Blatchford Score can be calculated before endoscopy using only clinical and laboratory data, while the complete Rockall score requires endoscopic findings. GBS is better at predicting need for intervention, whereas Rockall is better for predicting mortality.
When should urgent endoscopy be performed?
Urgent endoscopy (within 12-24 hours) is typically recommended for patients with high GBS scores (≥12), ongoing hemodynamic instability, suspected variceal bleeding, or high-risk clinical features. The score helps prioritize endoscopy timing.
Can GBS be used for lower GI bleeding?
No, the Glasgow-Blatchford Score is specifically validated for upper gastrointestinal bleeding only. Different risk stratification tools should be used for lower GI bleeding.
What interventions does the score predict?
The GBS predicts need for any of the following interventions: blood transfusion, endoscopic therapy (injection, banding, clips, thermal therapy), interventional radiology, or surgical intervention.
How should BUN be converted from mmol/L?
To convert BUN from mmol/L to mg/dL, multiply by 2.8. For example, 10 mmol/L = 28 mg/dL. The score uses mg/dL values, so conversion is necessary if your lab reports in mmol/L.
Is the score validated for all age groups?
Yes, the Glasgow-Blatchford Score has been validated across all adult age groups. Unlike some other scoring systems, it does not include age as a direct variable, though age may indirectly affect some parameters like comorbidities.
What is considered hepatic disease for scoring purposes?
Hepatic disease includes known chronic liver disease or cirrhosis. Clinical signs may include jaundice, ascites, or known varices. The presence of any documented liver disease qualifies for the 2-point addition.
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