Glasgow-Blatchford score, a risk predictor in upper Gastrointestinal Bleeding

Abstract

Background: Upper gastrointestinal bleeding (UGIB) is a frequent medical emergency. Given limitations for urgent endoscopy, pre-endoscopic clinical scores guide initial triage. This study aimed to determine the usefulness of the Glasgow-Blatchford Score (GBS) as a risk predictor at the Hospital Central in San Felipe, Venezuela. Methodology: Observational, descriptive, and cross-sectional study in 94 patients hospitalized for UGIB (N=94). GBS was calculated at admission, categorizing patients into Low Risk (0-1 point) and High Risk (>1 point). Association with transfusion requirement was evaluated using Chi-square (χ²) and Odds Ratio (OR) with 95% CI. Results: Males (56%) and the 66-85 age group (54%) predominated. Main presentations were hematemesis (54%) and melena (52%). Peptic ulcer was the most common specific cause (19%), though 49% lacked documented endoscopy. GBS classified 70% as High Risk. A statistically significant association was found between High Risk GBS and transfusion need (χ2=47.5; p<0.001), with an OR of 62.1 (95% CI: 7.9-490.1). Conversely, 96% of Low-Risk patients did not require blood products. Overall mortality was 6%, rising to 42% in critical care. Conclusions: The Glasgow-Blatchford Score is a highly accurate and safe pre-endoscopic predictor. Its strong ability to discriminate transfusion needs justifies its systematic implementation in emergency triage workflows.