Interpretation
| Result | Meaning |
|---|---|
| 0 | Very low risk (original Blatchford threshold) |
| ≤ 1 | Very low risk; outpatient management (ACG 2021, ESGE) |
| ≥ 2 | Admit; risk of intervention rises with score |
| ≥ 8 | High risk |
Formula
Urea (mmol/L) 6.5–<8 = 2, 8–<10 = 3, 10–<25 = 4, ≥25 = 6 · Hb men 12–<13 = 1, 10–<12 = 3, <10 = 6; women 10–<12 = 1, <10 = 6 · SBP 100–109 = 1, 90–99 = 2, <90 = 3 · Pulse ≥100 = 1 · Melena 1 · Syncope 2 · Hepatic disease 2 · Cardiac failure 2. (BUN mg/dL = urea mmol/L × 2.8)
Clinical pearls
- Urea thresholds are in mmol/L; BUN in mg/dL is converted by dividing by 2.8 (6.5 mmol/L ≈ BUN 18.2 mg/dL).
- Not validated for lower GI bleeding; use the Oakland score instead.
- A score of 0–1 has a negative predictive value above 99% for intervention or death.
Examples
blatchford bun 30 hb 9.5 male sbp 95 hr 110 melenaGlasgow-Blatchford for a woman with urea 6 mmol/L, Hb 13, BP 130/80, HR 80, no melena, syncope, liver disease or heart failuregbs 62M urea 9 hgb 11 sbp 105 hr 102 melena cirrhosis
FAQ
What Glasgow-Blatchford score can be discharged?
ACG 2021 suggests patients with a score of 0–1 can be managed as outpatients; the original study used 0.
Blatchford or Rockall?
Blatchford is better at identifying low-risk patients before endoscopy; full Rockall requires endoscopic findings and predicts mortality.