Glasgow-Blatchford Score

What This Calculator Measures

Calculates the Glasgow-Blatchford score to predict the need for endoscopic intervention, transfusion, or death in patients presenting with suspected upper gastrointestinal bleeding.

How to Use

1. Enter BUN, hemoglobin, systolic blood pressure, and pulse from the presentation, and select the patient's sex (hemoglobin scoring is sex-specific).
2. Indicate the presence of melena, syncope, known hepatic disease, and known cardiac failure.
3. A score of 0 identifies very low-risk patients in whom outpatient management may be appropriate.

Interpretation Guide

Glasgow-Blatchford 0 indicates very low risk, and outpatient management may be appropriate; 1–5 low risk with hospital assessment; 6–12 moderate risk with endoscopic evaluation; ≥13 high risk requiring urgent resuscitation and endoscopy.

Clinical Significance

A Glasgow-Blatchford score of 0 is supported by NICE guidance as identifying patients safe for outpatient management, helping avoid unnecessary admissions in low-risk upper GI bleeding.

When to Use

• Emergency department triage of suspected upper GI bleeding
• Deciding between admission and outpatient management
• Pre-endoscopy risk stratification

When Not to Use

• Established variceal bleeding, where portal-hypertension-specific scores apply
• Melena of uncertain gastrointestinal origin
• Children

Limitations

• BUN can be elevated by prerenal states unrelated to bleeding, inflating the score.
• The score estimates the need for intervention rather than predicting rebleeding.
• Validated chiefly in acute non-variceal upper GI bleeding.

Worked Example

A 58-year-old man with melena has BUN 35 mg/dL, hemoglobin 10.5 g/dL, SBP 105 mmHg, pulse 105 bpm, no syncope, and no known hepatic or cardiac disease.

Glasgow-Blatchford score = 4 (BUN) + 3 (hemoglobin) + 1 (SBP) + 1 (pulse) + 1 (melena) = 10 — moderate risk; endoscopic evaluation is recommended.

Evidence

Source

Original GBS Description / NICE Guideline

Reference

Blatchford O, et al. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet. 2000;356:1318-1321.

Reviewed By

MedCalcHub Clinical Team

Version

1.0

Updated

2026-08

1. Blatchford O, et al. Lancet. 2000;356:1318-1321.

References

1. Blatchford O, et al. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet. 2000;356:1318-1321. (Original score)