Gastrointestinal bleeding

Gastrointestinal Bleeding Pages

• Adults
  • Upper GI bleeding
    • Balloon tamponade for massive GI bleeding
    • Upper GI bleeding guidelines
    • EBQ:Omeprazole in Bleeding Peptic Ulcers
  • Lower GI bleeding
• Pediatrics
  • Gastrointestinal bleeding (peds)

Calculators

Glasgow-Blatchford Bleeding Score

Glasgow-Blatchford Bleeding Score (GBS)

Criteria	Select
BUN (mg/dL)	1 <18.2 (0)   18.2–22.3 (+2)   22.4–27.9 (+3)   28–69.9 (+4)   ≥70 (+6)
Hemoglobin — Male (g/dL)	1 ≥13 (0)   12–12.9 (+1)   10–11.9 (+3)   <10 (+6)
Hemoglobin — Female (g/dL)	1 ≥12 (0)   10–11.9 (+1)   <10 (+6)
Systolic BP (mmHg)	1 ≥110 (0)   100–109 (+1)   90–99 (+2)   <90 (+3)
Heart rate ≥100 (+1)	1 No   Yes
Melena (+1)	1 No   Yes
Syncope (+2)	1 No   Yes
Hepatic disease (+2)	1 No   Yes
Cardiac failure (+2)	1 No   Yes
GBS Score	/ 23

Interpretation

0	Very low risk — Can be considered for outpatient management. Virtually 0% chance of needing intervention.
1‒11	Moderate risk — Consider inpatient management and endoscopy.
≥12	High risk — Urgent intervention likely needed.

References

Blatchford O, et al. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet. 2000;356(9238):1318-1321. PMID 11073021. Stanley AJ, et al. Outpatient management of patients with low-risk upper-gastrointestinal haemorrhage: multicentre validation and prospective evaluation. Lancet. 2009;373(9657):42-47. PMID 19091393.