Criteria

Several risk scoring systems have been developed and validated, but each has been shown to perform most accurately to predict particular outcomes: for example, mortality, risk of rebleeding, need for transfusion, or the need for surgical or endoscopic therapy. International, American, and European upper gastrointestinal bleeding guidelines only recommend the Glasgow-Blatchford bleeding score (GBS) to identify, with high certainty, very low-risk patients who can be safely managed as outpatients.[39][40][42]

Glasgow-Blatchford bleeding score

The GBS (pre-endoscopy score) is calculated using the following parameters: blood urea nitrogen, hemoglobin, systolic blood pressure, pulse, melena, syncope, liver disease, and cardiac failure.[38][43]​​​​[44]​​​

Patients with a score of 0-1 are classified as very low-risk, which indicates a ≤1% false negative rate for requiring in-hospital interventions or death.[39][40][42]​ Patients with a score of ≥2 should be admitted promptly and receive an endoscopy within 24 hours.[1][39]​​​​ [ Blatchford score for gastrointestinal bleeding Opens in new window ]

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