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Calculator · Upper GI bleed — admit or discharge
Glasgow-Blatchford Score
Identifies upper GI bleed patients at low enough risk for outpatient management. A score of 0 (some centres use ≤1) may allow discharge without inpatient endoscopy. Unlike Rockall it needs no endoscopy, so it can be used at first contact.
What it asks
| Criterion | Points |
|---|---|
| Blood urea mmol/L | < 6.5 — 0 6.5 – 7.9 — 2 8.0 – 9.9 — 3 10.0 – 24.9 — 4 ≥ 25 — 6 |
| Haemoglobin g/L. Thresholds differ by sex — pick the matching row. | Men ≥ 130 / women ≥ 120 — 0 Men 120 – 129 — 1 Women 100 – 119 — 1 Men 100 – 119 — 3 Under 100 — either sex — 6 |
| Systolic blood pressure mmHg | ≥ 110 — 0 100 – 109 — 1 90 – 99 — 2 < 90 — 3 |
| Pulse ≥ 100 /min | No — 0 Yes — 1 |
| Melaena present | No — 0 Yes — 1 |
| Presentation with syncope | No — 0 Yes — 2 |
| Hepatic disease Known history or clinical/laboratory evidence of chronic liver disease | No — 0 Yes — 2 |
| Cardiac failure Known history or clinical/echocardiographic evidence | No — 0 Yes — 2 |
How to read the score
| Score | Means | What to do |
|---|---|---|
| 0 | Very low risk | Score 0 identifies patients who may be managed as outpatients with early endoscopy. Discuss with a senior before discharging anyone from an upper GI bleed pathway. |
| 1–5 | Low to intermediate risk | Admission and inpatient endoscopy usually indicated. Group and save, IV access, monitor. This band is practical guidance, not NICE — CG141 defines only a score of 0. |
| 6–23 | High risk | High likelihood of needing intervention — transfusion, endoscopic therapy or surgery. Escalate, activate the major haemorrhage protocol if unstable, and involve gastroenterology urgently. This band is practical guidance, not NICE. |
Before you use it
A score of 0 is the only cut-off with good evidence for outpatient management. Do not extend that to higher scores without senior agreement.
Source: NICE CG141 / Blatchford et al, Lancet 2000
Checked, and shown
Every threshold on this page was checked against its primary source by a practising doctor. Here is what that involved, and what it found.