Glasgow- Blatchford score for GI bleed A patient with a score of 0 has a minimal risk of needing an intervention like transfusion, endoscopy or surgery. Introduction The Glasgow Blatchford score is a risk scoring tool used to predict the need to treat patients presenting with upper gastrointestinal bleeding. Assess if intervention is required for acute upper GI bleeding.

Author: Kagrel Fenrijas
Country: Cambodia
Language: English (Spanish)
Genre: Travel
Published (Last): 26 April 2017
Pages: 441
PDF File Size: 8.76 Mb
ePub File Size: 10.81 Mb
ISBN: 447-3-36927-417-6
Downloads: 50162
Price: Free* [*Free Regsitration Required]
Uploader: Garamar

Gastroenterology training and education

With the ever-increasing demand on hospital and endoscopy services, the ability to differentiate between low risk no therapeutic intervention or transfusion needed and high risk likelihood of transfusion, therapeutic intervention, rebleeding or mortality provides a key opportunity for clinical prioritisation of both endoscopic interventions and hospital bed days.

Patients who did not have an endoscopy were excluded. Risk assessment after acute upper gastrointestinal haemorrhage. The GBS is a reliable and easy tool that can be used rapidly and by all clinicians to ascertain the urgency of investigation.

However it is not as good as the Rockall score in predicting overall mortality. Ethical approval was therefore not required and there were no conflicts of interests.

Score taken at hospital admission. In the end, individuals with the mean age of A range of pathologies were identified Fig 1. Screening of high risk patients and accelerating their treatment measures can reduce the burden of the disease caused by acute upper gastrointestinal GI bleeding. Upper gastrointestinal bleeding risk scores: Results Eighteen patients were excluded from the study due to failure to follow-up. Known-case of variceal bleeding patients and UGIB patients who received any treatment before admission were excluded.

Articles by Ang, Y. Comparison of scoring systems for nonvariceal upper gastrointestinal bleeding: Risk scoring systems to predict need for clinical intervention for patients with nonvariceal upper gastrointestinal tract bleeding.


Glasgow-Blatchford Bleeding Score (GBS) – MDCalc

Limitations Our study had some limitations. Well-validated in numerous populations. A receiver operating characteristic ROC curve was used to identify the best cutoff point in order to maximize the sensitivity and specificity of the two scoring systems to predict clinical outcomes mortality, rebleeding, need for endoscopic intervention, blood transfusion, and ICU admission of patients with UGIB.

In addition, we followed the cases for records of rebleeding and 1-month mortality. The cutoff points were considered zcore each system yielding high sensitivity but low specificity to predict these outcomes.

Glasgow-Blatchford score

No patients with a score of 3 required therapy. Extending the score to 2 and 3 reduced the NPV to Also, they showed high sensitivity of two systems for predicting transfusion need, against our study.

In terms of predicting rebleeding, the full RS system was superior to the GBS system, which is not the same as our study. In addition, for evaluating the agreement rate between the 2 models in predicting the patients in need of at least one intervention endoscopic, surgical, radiologic, or blood transfusion Kappa coefficient was calculated. Acute upper GI bleeding: The overall accuracy of the 2 models in predicting the mentioned outcomes was weak and the highest accuracy of the models belonged to predicting the probability of re-bleeding and need for blood transfusion, which were in the moderate range The Glasgow Blatchford score is the most accurate assessment of patients with upper gastrointestinal hemorrhage.

However, scorre that both patients required therapy, we recommend that patients with a history of liver disease and, hence, with possible varices, are managed more cautiously and are not suitable for discharge and early outpatient management. Frequency of patients in various quartiles of GBS and mGBS scores and the rate of need for at least 1 intervention in each quartile. Mitral Valve Area Hakki.

Glasogw-blatchford score higher than 0 is high risk for needing intervention: Diagnostic endoscopy was performed for all assigned patients on admission day or during the hospital stay. Journal List Clin Exp Gastroenterol v.


We followed the patients for records of rebleeding and 1-month mortality. Upper GI bleeding is a common reason for admission to hospital and, although it can lead to mortality, there is a range of causalities and a spectrum of severity on presentation.

Management of patients with ulcer bleeding. Comparison of three different risk scoring systems in non-variceal upper gastrointestinal bleeding. Quantification Volumetric Cardiology MS: Among this group there were no deaths or scire needed and people were able to be effectively treated in an outpatient setting. Expected spleen size Provides upper limit of normal for spleen length and volume by ultrasound relative to body height and gender.

The mean GBS was significantly higher in the patients with rebleeding than other cases 8.

Glasgow Blatchford Score and risk stratifications in acute upper gastrointestinal bleed: Methods Study design and setting In the present retrospective cross-sectional study, the diagnostic accuracy of GBS and mGBS models in predicting the outcome of patients with acute upper GI bleeding, presenting to the emergency departments of 3 teaching hospitals Imam Hossein, Shohadaye Tajrish, and TaleghaniTehran, Iran, from spring to winter 4 years were compared.

All calculations must be rechecked and should not be used alone to guide patient care. Log In Create Account. Coeliac Tropical sprue Blind loop syndrome Small bowel bacterial overgrowth syndrome Whipple’s Short bowel syndrome Steatorrhea Milroy disease Bile acid malabsorption. At the first stage of the study, six gastroenterologists performed endoscopies.

None of them effectively excluded the need for endoscopic intervention. Creating an account is free, easy, and takes about 60 seconds.