Glasgow-Blatchford Score Calculator

The Glasgow-Blatchford Score is a clinical risk stratification tool used to predict whether patients with acute upper gastrointestinal bleeding will require medical intervention such as blood transfusion, endoscopy, or surgery. It was developed by Blatchford et al. in 2000 and does not rely on endoscopic findings, making it useful at the point of initial presentation.

A GBS of 0 indicates very low risk and suggests the patient may be safely managed as an outpatient without urgent endoscopy or admission. Studies have shown that patients with a score of 0 have a less than 1% risk of needing intervention, making them candidates for early discharge.

A score of 7 or higher is generally considered high risk, indicating that the patient is very likely to need intervention such as endoscopy, blood transfusion, or surgery. Scores above 12 carry particularly high mortality risk and warrant urgent inpatient management.

BUN is scored on a tiered scale: 18.2–22.3 mg/dL earns 2 points, 22.4–27.9 mg/dL earns 3 points, 28.0–69.9 mg/dL earns 4 points, and ≥70 mg/dL earns 6 points. Elevated BUN reflects blood in the GI tract being digested and absorbed, raising the nitrogen load.

For males, hemoglobin 12.0–12.9 g/dL earns 1 point, 10.0–11.9 g/dL earns 3 points, and below 10 g/dL earns 6 points. For females, hemoglobin 10.0–11.9 g/dL earns 1 point and below 10 g/dL earns 6 points. Sex-based thresholds reflect the physiological differences in normal hemoglobin ranges.

No — the GBS is a pre-endoscopic triage tool, not a replacement for endoscopy. It helps clinicians decide who needs urgent endoscopic evaluation versus who can be safely managed conservatively or as an outpatient. All patients with significant GI bleeding should ultimately receive appropriate endoscopic assessment.

Clinical features that add points include a heart rate ≥ 100 bpm (+1), presentation with melena (+1), syncope at presentation (+2), known hepatic disease (+2), and known cardiac failure (+2). These findings indicate greater hemodynamic compromise or underlying comorbidities that worsen prognosis.

Systolic blood pressure (SBP) is scored as follows: SBP 100–109 mmHg earns 1 point, SBP 90–99 mmHg earns 2 points, and SBP below 90 mmHg earns 3 points. Normal SBP (≥110 mmHg) contributes 0 points. Lower blood pressure indicates hemodynamic instability and more severe bleeding.