Glasgow-Blatchford score for upper GI bleeding

The Glasgow-Blatchford score predicts the need for hospital intervention (transfusion, endoscopic therapy or surgery) in upper GI bleeding and identifies patients who can be managed as outpatients.

What goes into the Glasgow-Blatchford

BUN (mg/dL)
Hemoglobin (g/dL)
Sex: Male; Female
Systolic BP (mmHg)
Heart rate ≥ 100 (+1)
Melena (+1)
Presented with syncope (+2)
Hepatic disease (+2)
Cardiac failure (+2)

How to interpret the result

0–1: very low risk; outpatient management with early endoscopy is appropriate (ACG 2021)
2–7: needs inpatient assessment and endoscopy
≥ 8: high risk of needing intervention; resuscitate and arrange early endoscopy

Clinical pearls

Calculated before endoscopy from labs and vitals only, so it works at triage.
BUN rises with an upper GI bleed because blood is digested and absorbed.

Evidence

Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet. 2000;356:1318-1321.
Laine L, et al. ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding. Am J Gastroenterol. 2021;116:899-917.

Related workups

Upper GI bleed Lower GI bleed

Related calculators

MELD 3.0 and MELD-Na HAS-BLED All calculators

For education only. Check the inputs and the population the score was validated in before acting on it. Not a substitute for clinical judgment.