How it's calculated
Points are added from blood urea nitrogen, haemoglobin (with different thresholds for men and women), systolic blood pressure, and five additional clinical markers, for a total of 0-23. A score of 0 identifies patients at very low risk who can often be managed as outpatients.
Key thresholds
| Marker | Points |
|---|---|
| BUN, Hb, SBP | Banded 0–6 points each (see form) |
| Heart rate ≥100 bpm | 1 |
| Melena | 1 |
| Syncope | 2 |
| Hepatic disease | 2 |
| Cardiac failure | 2 |
Clinical use
- A Glasgow-Blatchford score of 0 is well validated for identifying patients with upper GI bleeding who can be safely managed as outpatients without endoscopy, reducing unnecessary admissions.
- Unlike the Rockall score, Glasgow-Blatchford does not require endoscopy findings, so it can be calculated entirely from information available before any endoscopic assessment.
- It predicts the need for intervention (transfusion, endoscopic therapy, or surgery) or death — it is not primarily designed to predict rebleeding after endoscopic treatment (Rockall is more suited to that question).
- Any score above 0 generally warrants admission and endoscopic assessment, though the specific management still depends on the full clinical picture.
Frequently asked questions
What is the Glasgow-Blatchford Score used for?
It estimates the likelihood that a patient with upper gastrointestinal bleeding will need an intervention (transfusion, endoscopy, or surgery), helping identify very low-risk patients who could be managed as outpatients.
What does a Glasgow-Blatchford score of 0 mean?
It identifies a very low-risk group who may be safely managed without hospital admission or urgent endoscopy, subject to overall clinical judgement and the ability to arrange timely follow-up.
Do I need endoscopy results to calculate this score?
No — unlike the Rockall score, Glasgow-Blatchford uses only information available before endoscopy (history, vitals, and basic labs), making it usable immediately at first assessment.
Why does the haemoglobin threshold differ between men and women?
Normal haemoglobin ranges differ by sex, so the score uses sex-specific thresholds to appropriately identify clinically significant anaemia in each group.
References
- Blatchford O, et al. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet. 2000;356:1318-1321.
- Stanley AJ, et al. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding. BMJ. 2017;356:i6432.
- National Institute for Health and Care Excellence (NICE). Acute upper gastrointestinal bleeding in over 16s: management.