The Predictive Value of Glasgow-Blatchford Score: The Experience of an Emergency Department.

Abstract

Upper gastrointestinal bleeding (UGB) is a common emergency and a major cause of morbidity and mortality worldwide. An early and accurate assessment at admission is essential to estimate the severity of each case, assisting in the management of patients. The Glasgow-Blatchford score (GBS) is currently recommended for risk stratificationof UGBin the emergency department (ED), helping triage patients to in-hospital vs. ambulatorymanagement. The aim of this study was to test the validity of the GBS in an ED. Patients who presented tothe ED with a diagnosis of UGB between 2017 and 2018 were retrospectively analyzed. The mean GBS value of the 149 patients included in the study was 10.3. Of the patients, 4.3% had values ≤1 and 8.7% had values ≤3. The sensitivity and negative predictive value for intervention needs (98.9% and 91.7%) and complications in 30 days (100% and 100%) remained high with a threshold ≤3. In the receiver operating characteristic curves, GBS presented an area under the curve of 0.883 and 0.625, regarding the need for intervention and complications in 30 days, respectively. In our population, the threshold ≤2, and eventually ≤3, allows the identification of twice as many low-risk patients, manageable as outpatients, without significant increases in interventionneeds or complications in 30 days.