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Evaluation of the Glasgow-Blatchford Score in Upper Gastro-Intestinal Hemorrhage, Outcomes and Prognosis: About a Series of Hospitalized Patients

Received: 20 April 2022    Accepted: 6 May 2022    Published: 12 May 2022
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Abstract

The Glasgow-Blatchford Score is based on simple clinical and biological variables that identifies patients who are at low or high risk for therapeutic procedures (interventional endoscopy, surgery and/or transfusions). The aim of this work is to evaluate the prognostic contribution of the Glasgow-Blatchford score GBS during upper gastro-intestinal bleeding. Materials and methods: This is a prospective study from April 2020 to July 2021, involving patients who were hospitalized for upper GI bleeding. All patients underwent biological assessment, FOGD and therapeutic management. Follow-up was done during hospitalization and by telephone consultation after discharge. The analytical study was done using SPSS software. Results: The study included 73 patients with gastro-intestinal bleeding: hematemesis in 17 patients (23.28%), hematemesis and melena in 25 patients (34.24%), melena in 29 patients (39.72%) and rectorrhage in 8 patients (10.95%). The mean age was 56.5 years with a sex ratio (F/H)=1.28. The main diagnoses found were bleeding on portal hypertension in 13 patients (17%), gastro-duodenal ulcer in 23 patients (31.5%), gastric tumor in 4 patients (5%), angiodysplasias in 5 patients (6.8%), peptic esophagitis in (4%). endoscopy was normal in 12 patients (16%). The median GBS was 9 (6-10). The prevalence of hemorrhagic recurrence was 25.2%. Comparison of the two groups: Group 1 (who did not recur) and Group 2 (who recurred) showed a higher mean GBS in Group 2 which was 8 (4-10) compared to 5 (3-7) in Group 1 with (p=0.03). The median GBS was elevated to 9 (6-10) in the transfused group, compared to 6 (7-10) in the non-transfused group with a p=0.47. The median score in patients with normal fibroscopy is 7 (4.5-10) compared to patients with a bleeding endoscopic lesion which is 9 (6-10) with a p=0.19. Conclusion: The GBS is an easy prognostic score to assess in patients with upper GI bleeding. This score predicts the prognosis and the risk of recurrence of bleeding. Further studies are needed for a better discussion of this issue.

Published in International Journal of Medical Case Reports (Volume 1, Issue 1)
DOI 10.11648/j.ijmcr.20220101.12
Page(s) 6-8
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Glasgow-Blatchford Score, Hemorrhage, Fibroscopy, Prognosis

References
[1] Terdiman JP. Update on upper gastrointestinal bleeding. Basing treatment decisions on patients’ risk level. Postgrad Med 1998.
[2] Van Leerdam ME et al. Acute upper GI bleeding: did anything change? Time trend analysis of incidence and outcome of acute upper GI bleeding between 1993/1994 and 2000. Am J Gastroenterol 2003.
[3] Barkun AN, et al. International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med 2010.
[4] Saeed ZA, et al. A scoring system to predict rebleeding after endoscopic therapy of non-variceal upper gastrointestinal hemorrhage. Am J Gastroenterol 1993.
[5] Hay JA, et al. Upper gastrointestinal hemorrhage clinical guideline: determining the optimal hospital length of stay. Am J Med 1996.
[6] Blatchford O, et al. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet 2000.
[7] Rockall TA, et al. Risk assessment after acute upper gastrointestinal haemorrhage. Gut 1996.
[8] Gralnek IM, et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015.
[9] Kim MS, Choi J, Shin WC. AIMS65 scoring system is comparable to Glasgow-Blatchford score or Rockall score for prediction of clinical outcomes for non-variceal upper gastrointestinal bleeding. BMC Gastroenterol. 2019.
[10] Robertson M, et al. Risk stratification in acute upper GI bleeding: comparison of the AIMS65 score with the Glasgow-Blatchford and Rockall scoring systems. Gastrointest Endosc. 2016.
[11] Lu M, et al. Comparison of the Glasgow-Blatchford and Rockall Scores for prediction of nonvariceal upper gastrointestinal bleeding outcomes in Chinese patients. Medicine (Baltimore). 2019.
[12] Stanley AJ, et al.; International Gastrointestinal Bleeding Consortium. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study. BMJ. 2017.
[13] Chandnani S, et al. Comparison ofrisk scores in upper gastrointestinal bleedingin western India: A prospective analysis. Indian J Gastroenterol. 2019.
[14] Barkun AN, et al. Management of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group. Ann Intern Med. 2019.
[15] Mokhtare M, et al. Comparison of Glasgow-Blatchford score and full Rockall score systems to predict clinical outcomes inpatients with upper gastrointestinal bleeding. Clin Exp Gastroenterol. 2016.
[16] Maia, S., et al. The clinical impact of Rockall and Glasgow-Blatchford scores in nonvariceal upper gastrointestinal bleeding. GE-Portuguese Journal of Gastroenterology, 2021.
[17] Samuel R, et al. Evaluation and management of Non-variceal upper gastrointestinal bleeding. Dis Mon. 2018.
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    Boutaina Bouibaouen, Hicham El Bacha, Nadia Benzzoubeir, Tarik Gharbi, Ikram Errabih. (2022). Evaluation of the Glasgow-Blatchford Score in Upper Gastro-Intestinal Hemorrhage, Outcomes and Prognosis: About a Series of Hospitalized Patients. International Journal of Medical Case Reports, 1(1), 6-8. https://doi.org/10.11648/j.ijmcr.20220101.12

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    Boutaina Bouibaouen; Hicham El Bacha; Nadia Benzzoubeir; Tarik Gharbi; Ikram Errabih. Evaluation of the Glasgow-Blatchford Score in Upper Gastro-Intestinal Hemorrhage, Outcomes and Prognosis: About a Series of Hospitalized Patients. Int. J. Med. Case Rep. 2022, 1(1), 6-8. doi: 10.11648/j.ijmcr.20220101.12

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    AMA Style

    Boutaina Bouibaouen, Hicham El Bacha, Nadia Benzzoubeir, Tarik Gharbi, Ikram Errabih. Evaluation of the Glasgow-Blatchford Score in Upper Gastro-Intestinal Hemorrhage, Outcomes and Prognosis: About a Series of Hospitalized Patients. Int J Med Case Rep. 2022;1(1):6-8. doi: 10.11648/j.ijmcr.20220101.12

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  • @article{10.11648/j.ijmcr.20220101.12,
      author = {Boutaina Bouibaouen and Hicham El Bacha and Nadia Benzzoubeir and Tarik Gharbi and Ikram Errabih},
      title = {Evaluation of the Glasgow-Blatchford Score in Upper Gastro-Intestinal Hemorrhage, Outcomes and Prognosis: About a Series of Hospitalized Patients},
      journal = {International Journal of Medical Case Reports},
      volume = {1},
      number = {1},
      pages = {6-8},
      doi = {10.11648/j.ijmcr.20220101.12},
      url = {https://doi.org/10.11648/j.ijmcr.20220101.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmcr.20220101.12},
      abstract = {The Glasgow-Blatchford Score is based on simple clinical and biological variables that identifies patients who are at low or high risk for therapeutic procedures (interventional endoscopy, surgery and/or transfusions). The aim of this work is to evaluate the prognostic contribution of the Glasgow-Blatchford score GBS during upper gastro-intestinal bleeding. Materials and methods: This is a prospective study from April 2020 to July 2021, involving patients who were hospitalized for upper GI bleeding. All patients underwent biological assessment, FOGD and therapeutic management. Follow-up was done during hospitalization and by telephone consultation after discharge. The analytical study was done using SPSS software. Results: The study included 73 patients with gastro-intestinal bleeding: hematemesis in 17 patients (23.28%), hematemesis and melena in 25 patients (34.24%), melena in 29 patients (39.72%) and rectorrhage in 8 patients (10.95%). The mean age was 56.5 years with a sex ratio (F/H)=1.28. The main diagnoses found were bleeding on portal hypertension in 13 patients (17%), gastro-duodenal ulcer in 23 patients (31.5%), gastric tumor in 4 patients (5%), angiodysplasias in 5 patients (6.8%), peptic esophagitis in (4%). endoscopy was normal in 12 patients (16%). The median GBS was 9 (6-10). The prevalence of hemorrhagic recurrence was 25.2%. Comparison of the two groups: Group 1 (who did not recur) and Group 2 (who recurred) showed a higher mean GBS in Group 2 which was 8 (4-10) compared to 5 (3-7) in Group 1 with (p=0.03). The median GBS was elevated to 9 (6-10) in the transfused group, compared to 6 (7-10) in the non-transfused group with a p=0.47. The median score in patients with normal fibroscopy is 7 (4.5-10) compared to patients with a bleeding endoscopic lesion which is 9 (6-10) with a p=0.19. Conclusion: The GBS is an easy prognostic score to assess in patients with upper GI bleeding. This score predicts the prognosis and the risk of recurrence of bleeding. Further studies are needed for a better discussion of this issue.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Evaluation of the Glasgow-Blatchford Score in Upper Gastro-Intestinal Hemorrhage, Outcomes and Prognosis: About a Series of Hospitalized Patients
    AU  - Boutaina Bouibaouen
    AU  - Hicham El Bacha
    AU  - Nadia Benzzoubeir
    AU  - Tarik Gharbi
    AU  - Ikram Errabih
    Y1  - 2022/05/12
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijmcr.20220101.12
    DO  - 10.11648/j.ijmcr.20220101.12
    T2  - International Journal of Medical Case Reports
    JF  - International Journal of Medical Case Reports
    JO  - International Journal of Medical Case Reports
    SP  - 6
    EP  - 8
    PB  - Science Publishing Group
    SN  - 2994-7049
    UR  - https://doi.org/10.11648/j.ijmcr.20220101.12
    AB  - The Glasgow-Blatchford Score is based on simple clinical and biological variables that identifies patients who are at low or high risk for therapeutic procedures (interventional endoscopy, surgery and/or transfusions). The aim of this work is to evaluate the prognostic contribution of the Glasgow-Blatchford score GBS during upper gastro-intestinal bleeding. Materials and methods: This is a prospective study from April 2020 to July 2021, involving patients who were hospitalized for upper GI bleeding. All patients underwent biological assessment, FOGD and therapeutic management. Follow-up was done during hospitalization and by telephone consultation after discharge. The analytical study was done using SPSS software. Results: The study included 73 patients with gastro-intestinal bleeding: hematemesis in 17 patients (23.28%), hematemesis and melena in 25 patients (34.24%), melena in 29 patients (39.72%) and rectorrhage in 8 patients (10.95%). The mean age was 56.5 years with a sex ratio (F/H)=1.28. The main diagnoses found were bleeding on portal hypertension in 13 patients (17%), gastro-duodenal ulcer in 23 patients (31.5%), gastric tumor in 4 patients (5%), angiodysplasias in 5 patients (6.8%), peptic esophagitis in (4%). endoscopy was normal in 12 patients (16%). The median GBS was 9 (6-10). The prevalence of hemorrhagic recurrence was 25.2%. Comparison of the two groups: Group 1 (who did not recur) and Group 2 (who recurred) showed a higher mean GBS in Group 2 which was 8 (4-10) compared to 5 (3-7) in Group 1 with (p=0.03). The median GBS was elevated to 9 (6-10) in the transfused group, compared to 6 (7-10) in the non-transfused group with a p=0.47. The median score in patients with normal fibroscopy is 7 (4.5-10) compared to patients with a bleeding endoscopic lesion which is 9 (6-10) with a p=0.19. Conclusion: The GBS is an easy prognostic score to assess in patients with upper GI bleeding. This score predicts the prognosis and the risk of recurrence of bleeding. Further studies are needed for a better discussion of this issue.
    VL  - 1
    IS  - 1
    ER  - 

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Author Information
  • Department of Hepato-Gastro-Enterology and Proctology, Ibn Sina Hospital, Rabat, Morocco

  • Department of Hepato-Gastro-Enterology and Proctology, Ibn Sina Hospital, Rabat, Morocco

  • Department of Hepato-Gastro-Enterology and Proctology, Ibn Sina Hospital, Rabat, Morocco

  • Department of Hepato-Gastro-Enterology and Proctology, Ibn Sina Hospital, Rabat, Morocco

  • Department of Hepato-Gastro-Enterology and Proctology, Ibn Sina Hospital, Rabat, Morocco

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