The Glasgow Blatchford scoring system enables accurate risk stratification of patients with upper gastrointestinal haemorrhage

Abstract

The GBS accurately identifies low risk patients who could be managed safely as outpatients.

Prospective validation of the Glasgow Blatchford scoring system in patients with upper gastrointestinal bleeding in the emergency department

“…Endoscopic results in the low-and high-risk groups of patients An ideal scoring system should have both a good sensitivity and high specificity. However, in the studies conducted, the sensitivity and specificity of the GBS system vary among high-risk patients with UGI system bleeding (10,12,13). In our study, the sensitivity and specificity were 100% and 1.41% for a cut-off value of GBS >0, 100% and 16.9% for a cut-off value of GBS >3, 96.63% and 36.62% for a cut-off value of GBS >5, and 86.52% and 69.01% for a cut-off value of GBS >8.…”

“…Although in the literature, there has been no consensus on the best scoring system in various studies performed using the Rockall scoring system and/or the GBS system (3,10,(12)(13)(14)(15)(16)(17), the GBS system seems to be more useful, especially in patients with non-variceal UGI system bleeding. In our study, which included all the patients with variceal and non-variceal UGI system bleeding, we used the GBS system, and found it useful in the differentiation of high-risk patients.…”

Upper gastrointestinal bleeding risk scores: Who, when and why?

“…In this cohort of patients the 28 d mortality rate was 0 [43] . The GBS has been shown to be as good as the Rockall score in predicting the need for any intervention, namely the need for therapeutic endoscopy [41,42,[44][45][46][47] . The GBS has also been shown to be superior to the clinical Rockall score in identifying patients with suspected UGIB who have a low likelihood of an adverse clinical outcome (blood transfusion, endoscopic therapy, interventional radiology, surgery or 30 d mortality) and can be considered for early discharge [48] .…”

“…The reported conclusion is that the modified GBS performed as well as the full GBS while outperforming both clinical and endoscopic Rockall Scores for prediction of clinical outcomes [51] . Some studies have suggested that the rate of identified lowrisk patients could be increased by using a higher GBS cut-off value [45,[52][53][54][55][56][57] or by incorporating age as a variable [52,58] .…”

“…Although with high sensitivity to identify patients at high risk for developing the need for blood transfusion, endoscopic therapy, or surgical intervention, the GBS has a low specificity [44,45,48,56,68,69] . Advanced age is a risk factor for death [70] and lowrisk patients in general are younger than high-risk patients with UGIB.…”