title: The predictive capacity of the Glasgow-Blatchford score for the risk stratification of upper gastrointestinal bleeding in an emergency department.
abstract: OBJECTIVE
  To assess the ability of the Glasgow Blatchford Score (GBS) system to identify the need for urgent upper gastrointestinal endoscopy (UGIE) in patients with upper gastrointestinal bleeding (UGIB).
  
  
  METHODS
  An observational, retrospective study was carried out in all patients attended at the ER for suspected UGIB in one year. Patients were split into two categories -high-risk (>2) and low-risk ( < or = 2)- by means of the GBS system.
  
  
  RESULTS
  A total of 60 patients were included. Of these, 46 were classified as "high-risk" (> 2) and 14 as "low-risk" ( < or = 2) subjects.The characteristics of patients in the low-risk group included: Mean age: 46.6 +/- 13.7 (18-88) years. Males/females: 7/7. Urgent endoscopy revealed: normal (50%; n = 7); esophagitis (21.4%; n = 3); gastritis (14.2%; n = 2); Mallory-Weiss syndrome (7.1%; n = 1); non-bleeding varices (7.1%; n = 1). The characteristics of patients in the high-risk group included: Mean age: 68.7 +/- 19.8 (31-91) years. Males/females: 30/16. Digestive endoscopy revealed: Gastric/duodenal ulcer (56.52%; n = 26); normal (17.39%; n = 8); esophagitis (8.69%; n = 4); gastritis (8.69%; n = 4); angioectasia (4.34%; n = 2); bleeding varices (4.34%; n = 2). Low-risk patients exhibited no lesions requiring urgent management during endoscopy, and the sensitivity of the GBS scale for high-risk UGIB detection was found to be 100% (95% CI: 86.27%, 99.71%), with a specificity of 48.28% (95% CI: 29.89, 67.1%).
  
  
  CONCLUSIONS
  The GBS scale seems to accurately identify patients with low-risk UGIB, who may be managed on an outpatient basis and undergo delayed upper GI endoscopy at the outpatient clinic.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Recio-Ramírez
authors.forename: María del Pilar
authors.initials: Mdel P
authors.lastname: Sánchez-Sánchez
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Peña-Ojeda
authors.forename: Enrique
authors.initials: E
authors.lastname: Fernández-Romero
authors.forename: Manuel
authors.initials: M
authors.lastname: Aguilera-Peña
authors.forename: Emilio
authors.initials: E
authors.lastname: del-Campo-Molina
authors.forename: José Luis
authors.initials: JL
authors.lastname: Zambrana-García
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003661:Decision Support Techniques; D004636:Emergency Service, Hospital; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D055815:Young Adult