Discharge Deemed Safe for Select Upper GI Bleeders
By: M. ALEXANDER OTTO, Elsevier Global Medical News 04/19/12
EXPERT ANALYSIS FROM THE ANNUAL MEETING OF THE
SOCIETY OF HOSPITAL MEDICINE
SAN DIEGO – A Glasgow-Blatchford bleeding score of zero identifies a subset of upper GI bleeders who can be sent home from the ED and safely managed as outpatients, according to gastroenterologist Dr. Derek Patel at the annual meeting of the Society of Hospital Medicine.
"Less than 1% of patients you send home with a Blatchford score of zero will require" therapeutic endoscopy, transfusion, or surgery. A zero score is "a reasonable predictor for not requiring therapeutic intervention," said Dr. Patel, associate clinical professor of medicine at the University of California, San Diego.
The scale was specifically designed to predict who’ll need intervention for upper GI bleeding. A score of zero translates to a blood urea nitrogen (BUN) below 18.2 mg/dL; hemoglobin of at least 13 g/dL for men and 12 g/dL for women; systolic blood pressure above 109 mmHg; pulse below 100 bpm; no melena at presentation; and no syncope, liver disease, or heart failure.
http://www.acepnews.com/news/clinical/single-article/08f011237f053236d65641af382a15df.html?tx_ttnews%5Btt_news%5D=1261
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GLASGOW-BLATCHFORD BLEEDING SCORE (GBS)