Glasgow-Blatchford Score
Identifies upper GI bleed patients safe for outpatient management. Score 0 has very low risk.
How to use & interpret
The Glasgow-Blatchford score (GBS) risk-stratifies upper gastrointestinal bleeding at presentation, before endoscopy, using blood urea, haemoglobin, systolic BP, pulse, melaena, syncope, and liver/cardiac disease. Its strength is identifying very-low-risk patients.
A score of 0 (some pathways use ≤1) identifies patients at very low risk of needing intervention or dying, who may be considered for outpatient management. Higher scores predict the need for transfusion, endoscopic therapy or surgery and support admission and timely endoscopy. Use the (post-endoscopy) Rockall score for mortality risk after the procedure.
Score interpretation
Score 0: Very low risk. Outpatient endoscopy appropriate. Mortality ~0%.
→ Safe for outpatient management. Outpatient endoscopy within 24–72 hours. Avoid NSAIDs/aspirin.
Score 1–5: Low risk. Inpatient endoscopy within 24 hours.
→ Admit. IV access. NBM from midnight. Endoscopy next morning. PPI infusion if Rockall ≥3.
Score ≥6: High risk. Need intervention likely.
→ Urgent endoscopy within 24 hours (or sooner if haemodynamically unstable). IV PPI. Resuscitate. GI/surgical review.
Interpretation bands for the GBS. Apply clinical judgement and local guidance.
Frequently asked questions
Glasgow-Blatchford or Rockall?
GBS is calculated at presentation (pre-endoscopy) and is best for identifying low-risk patients for early discharge; the full Rockall score includes endoscopic findings and predicts rebleeding and mortality afterwards.
References
- Blatchford O et al. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet. 2000.
Related
Curated clinical cross-links plus same-class fallbacks.
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
Featured in these MRCEM clinical pathways
The GBS is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.