Glasgow-Blatchford score

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First developed in 2000 as a clinical stratifying score in acute upper gastrointestinal bleeding. Five studies have validated the use of a score of 0 at first presentation as low risk patients suitable for consideration of outpatient management[1][2][3][4][5][6]. It has now been demonstrated in British practice to be superior to the Rockall score in determining who is safe to discharge home and be managed as an outpatient setting which may be about 15% of such presentations[7]. It is also somewhat superior to the Rockall score in predicting who will not need a hospital based intervention for their pathology related to the haemorrhage. However it is not as good as the Rockall score in predicting overall mortality of all who present with a upper gastrointestinal bleed.

References

  1. Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet. 2000 Oct 14; 356(9238):1318-21.(Link to article – subscription may be required.)
  2. Gralnek IM, Dulai GS. Incremental value of upper endoscopy for triage of patients with acute non-variceal upper-GI hemorrhage. Gastrointestinal endoscopy. 2004 Jul; 60(1):9-14.
  3. Romagnuolo J, Barkun AN, Enns R, Armstrong D, Gregor J. Simple clinical predictors may obviate urgent endoscopy in selected patients with nonvariceal upper gastrointestinal tract bleeding. Archives of internal medicine. 2007 Feb 12; 167(3):265-70.(Link to article – subscription may be required.)
  4. 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; 25(7):774-9.(Link to article – subscription may be required.)
  5. Masaoka T, Suzuki H, Hori S, Aikawa N, Hibi T. Blatchford scoring system is a useful scoring system for detecting patients with upper gastrointestinal bleeding who do not need endoscopic intervention. Journal of gastroenterology and hepatology. 2007 Sep; 22(9):1404-8.(Link to article – subscription may be required.)
  6. Stanley A, Ashley D, Dalton H, Mowat C, Gaya D, Thompson E, Warshow U, Groome M, Cahill A, Benson G, Blatchford O, Murray W. Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation. Lancet. 2008 Dec 15.(Epub ahead of print) (Link to article – subscription may be required.)
  7. Stanley A, Ashley D, Dalton H, Mowat C, Gaya D, Thompson E, Warshow U, Groome M, Cahill A, Benson G, Blatchford O, Murray W. Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation. Lancet. 2008 Dec 15.(Epub ahead of print) (Link to article – subscription may be required.)
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