The Glasgow-Blatchford score uses urea, haemoglobin, systolic pressure, pulse, melaena, syncope, liver disease and heart failure, all available at triage. A score of 0 or 1 identifies patients who can usually be managed as outpatients with early endoscopy.
Higher scores mean higher risk, but as today's meta-analysis suggests, the clock on the endoscope matters less than resuscitation.
- Calculate the Glasgow-Blatchford score in every suspected upper GI bleed.
- A score of 0 or 1 supports outpatient management with endoscopy arranged promptly.
- Use a restrictive transfusion threshold (haemoglobin 70 g/L; 80 g/L with cardiovascular disease).
- Start intravenous PPI in suspected peptic bleeding, but do not let it delay endoscopy in unstable patients.
Why it matters
Most upper GI bleeds are low risk, and a validated score keeps them out of hospital safely.
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