Upper GI Bleeding - Risk Scoring Systems

It is increasingly recognized that early risk assessment is an important part of management, which helps direct appropriate patient care and the timing of endoscopy. Several risk scores have been developed, most of which include endoscopic findings, although a minority do not.

The Glasgow Blatchford Score (GBS)

  • Is the most relevant score for the purposes of Emergency management as it can be calculated prior to endoscopy

  • It was developed in 2000 to predict the need for hospital based intervention (transfusion, endoscopic therapy, or surgery) or death following UGIH.

  • It predicts the need for inpatient care for the purposes of endoscopy and transfusion.

  • Six recent studies from United Kingdom and Taiwan have shown the GBS to be superior to the admission Rockall score in predicting need for clinical intervention or death. The GBS has also been shown to be superior to both the full and admission Rockall scores in predicting need for transfusion.

Patients with a GBS score of 0 may be suitable for discharge.

Higher risk groups require in-patient endoscopy for full evaluation and therapy

 

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