Management of minor upper gastrointestinal haemorrhage in the community using the Glasgow Blatchford Score

Eur J Gastroenterol Hepatol. 2009 Dec;21(12):1340-6. doi: 10.1097/MEG.0b013e32831bc3ec.


Background: The Glasgow Blatchford Score (GBS) is a validated risk assessment tool in primary upper gastrointestinal haemorrhage, which accurately predicts the need for intervention (endoscopic therapy, blood transfusion or surgery) or death.

Aims: To identify the GBS that predicts lack of intervention or death and to apply this to clinical practice by managing low-risk patients in the community.

Methods: GBSs prospectively calculated on 232 patients with upper gastrointestinal haemorrhage to identify low-risk score. Patients with low-risk of requiring intervention (GBS <or=2, age <70 years) from a further 304 patients were considered for management in the community.

Results: Fifty-two of 232 patients in the first cohort had a GBS <or=2 and were aged less than 70 years: none of these required intervention or died. In the second cohort 104 of 304 (34.2%) patients had a GBS <or=2 and were aged less than 70 years, none of whom died or required endoscopic therapy, blood transfusion, surgery or died. Thrity-two of 104 (10.5% of total cohort) were safely managed in the community.

Conclusion: Using the criteria of a GBS <or=2, aged less than 70 years to define patients at 'low risk' allows 10.5% of patients with primary upper gastrointestinal haemorrhage to be safely managed in the community.

MeSH terms

  • Age Factors
  • Aged
  • Blood Transfusion
  • Community Health Services / methods*
  • England
  • Epidemiologic Methods
  • Female
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / therapy*
  • Hemostasis, Endoscopic
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Severity of Illness Index*