![]() ![]() The low risk scenario presentation should respect the following clinical and laboratory variables: Low risk patients even suffering from hematemesis can be monitored outpatient but are still in need for endoscopy, although in their case is rather elective than compulsory. Scores of 6 or more have an increased risk of acute upper gastrointestinal bleeding (UGIB) of over 50% to need surgical intervention, blood transfusion or endoscopic intervention. Scores of 0 are considered low risk while all scores above 0 are deemed high risk for upper gastro intestinal bleeding. Once the risk stratification system is completed, the clinician will obtain a score ranging from 0 to 23. One of the criticisms of the Blatchford bleeding model is that it can only be used for patient with upper GI bleeding and not for lower GI where the source of hemorrhage might not be clear.Īnother useful score used in gastrointestinal bleeding management is the pre endoscopic Rockall score, for mortality risk but in comparison to the Glasgow Blatchford, although both systems can be assessed at first presentation, the Rockall one is a lot more subjective with the clinician being allowed to assess the severity of systemic disease while Blatchford focuses on symptoms. ■ Presentation with melena – sign of diffuse bleeding, with or without known cause in the gastrointestinal track. ![]() ■ History of hepatic disease with either chronic or acute liver disease or any kind of fibrosis, cirrhosis related or not. ■ History of cardiac disease by echocardiography evidence and any signs of cardiac failure in the past or present. ■ Presentation with syncope – syncope is one of the first signs of hemorrhage, transient loss of conscience, hypotension. ■ Systolic blood pressure (mmHg) – along with heart rate – monitor the overall condition of the cardiovascular system, the higher the values, the greater the risk for the patient. The higher Hb value, the less risk for bleeding. ■ Hemoglobin (g/dL) – discerning whether the patient is male and female with the scoring system varying slightly by gender. ■ Blood Urea (mmol/L) – the lower the BUN determination is, the lower the risk for hemorrhage and intervention in the upper GI. The Glasgow-Blatchford score (GBS) calculator works as a screening form checking the likelihood of upper digestive hemorrhage based on the following criteria: This health tool allows the stratification of patients at risk for bleeding in the upper gastro intestinal track and helps the clinician set the inpatient or outpatient management. How does this Glasgow-Blatchford score (GBS) calculator work? ![]()
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