The Glasgow-Blatchford score uses urea, haemoglobin, systolic blood pressure, pulse, melaena, syncope, liver disease and heart failure — all available before endoscopy. Patients scoring 0 or 1 have a very low risk of needing intervention or dying, and guidelines support outpatient endoscopy for them. Admitting them uses a bed without improving outcomes; the higher the score, the stronger the case for admission, but a high score alone does not demand scoping within hours.
- Calculate the Glasgow-Blatchford score in every suspected upper GI bleed before deciding on admission.
- A score of 0–1 supports discharge with early outpatient endoscopy if the patient can return reliably.
- Urea is weighted heavily: a raised urea with normal creatinine suggests upper GI blood.
- Recalculate after resuscitation; tachycardia and hypotension that correct change the picture.
Why it matters
A validated score at the front door frees beds for the patients who need them.
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