The Predictive Value of Glasgow-Blatchford Score: The Experience of an Emergency Department

Abstract

Introduction: Upper gastrointestinal bleeding (UGB) is a common emergency and a major cause of morbidity and mortality worldwide. An early and accurate assessment at admission is essential to estimate the severity of each case, assisting in the management of patients. The Glasgow-Blatchford score (GBS) is currently recommended for risk stratification of UGB in the emergency department (ED), helping triage patients to inhospital vs. ambulatory management. The aim of this study was to test the validity of the GBS in an ED.Methods: Patients who presented to the ED with a diagnosis of UGB between 2017 and 2018 were retrospectively analyzed.Results: The mean GBS value of the 149 patients included in the study was 10.3. Of the patients, 4.3% had values ≤1 and 8.7% had values ≤3. The sensitivity and negative predictive value for intervention needs (98.9% and 91.7%) and complications in 30 days (100% and 100%) remained high with a threshold ≤3. In the receiver operating characteristic curves, GBS presented an area under the curve of 0.883 and 0.625, regarding the need for intervention and complications in 30 days, respectively. Conclusions: In our population, the threshold ≤2, and eventually ≤3, allows the identification of twice as many low-risk patients, manageable as outpatients, without significant increases in intervention needs or complications in 30 days.

Assessing the Predictive Factors for Bleeding in Esophageal Variceal Disease: A Systematic Review

“…Several scoring systems have been developed for the assessment of patients with UGB to predict clinical outcomes. The most frequently used are the Rockfall score, the Glasgow-Blatchford score (GBS), and AIMS65 (albumin, international normalized ratio (INR), mental status, systolic blood pressure, age >65 years) [ 4 ]. However, these scoring systems are limited to assessing post-bleed risk [ 5 ], leaving​ a critical gap in predicting the initial bleeding episode.…”