GBS v.1
A risk-stratification system for patients with acute upper-gastrointestinal bleeding (UGIB), to discriminate between patients at high or low risk of dying or rebleeding. The score is calculated based on clinical and laboratory variables only: patients' admission haemoglobin, blood urea, pulse, and systolic blood pressure, as well as presentation with syncope or melaena, and evidence of hepatic disease or cardiac failure. Component points assigned for presence, absence, or value of each variable are summed to give the Glasgow-Blatchford bleeding score (GBS) with value between 0 - 23. A score above 0 (zero) implies the patient is at high risk of needing clinical intervention (transfusion, endoscopy or surgery), and correlates well with length of hospital stay and number of units of blood transfused. GBS is more sensitive than clinical and complete Rockall scores for identifying high-risk patients with acute UGIB.
To stratify patients with acute UGIB into low or high risk groups for needing treatment, rebleeding or mortality.
To calculate the Glasgow-Blatchford bleeding score and stratify patients with acute UGIB as low or high risk of needing treatment (blood transfusion, endoscopy or surgery), rebleeding, or dying. Points are assigned for patients' admission haemoglobin (0 - 6), blood urea (0 - 6), pulse rate (0 -1), and systolic blood pressure (0 -3), as well as presentation with syncope (0 - 2) or melaena (0 - 1), and evidence of hepatic disease (0 - 2) or cardiac failure (0 - 2). The points are summed to give a total score (Glasgow-Blatchford bleeding score) between 0 - 23, with score of 0 (zero) suggesting a low risk of complications (0.5%) and higher scores corresponding to increasing acuity, need for treatment, duration of hospital stay, and mortality. Blood urea concentration is given as mg/dl (divide by 0.3571 to convert from mmol/L to mg/dl), while haemoglobin concentration is given as g/dl (divide by 10 to convert from g/L to g/dl).
Should only be used with clinical and laboratory values obtained at initial patient assessment.
Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for uppergastrointestinal haemorrhage. The Lancet. 2000 Oct 14;356(9238):1318-21. Chen IC, Hung MS, Chiu TF, Chen JC, Hsiao CT. Risk scoring systems to predict need for clinical intervention for patients with nonvariceal upper gastrointestinal tract bleeding. The American journal of emergency medicine. 2007 Sep 30;25(7):774-9. Srirajaskanthan R, Conn R, Bulwer C, Irving P. The Glasgow Blatchford scoring system enables accurate risk stratification of patients with upper gastrointestinal haemorrhage. International journal of clinical practice. 2010 Jun 1;64(7):868-74.
OBSERVATION.lab_test-full_blood_count.v1, OBSERVATION.lab_test-urea_and_electrolytes.v1, OBSERVATION.blood_pressure.v2, OBSERVATION.basic_demographic.v1, OBSERVATION.pulse.v2, OBSERVATION.glasgow_blatchford_bleeding_score.v1, OBSERVATION.history_prior_medical_diagnosis.v1, EVALUATION.glasgow_blatchford_bleeding_score_assessment.v1
