[Is there a place for the Glasgow-Blatchford score in the management of upper gastrointestinal bleeding?]

Hichem Jerraya, Amine Bousslema, Foued Frikha, Chadli Dziri
La Tunisie Médicale 2011, 89 (12): 916-9

BACKGROUND: Upper gastrointestinal bleeding is a frequent cause for emergency hospital admission. Most severity scores include in their computation the endoscopic findings. The Glasgow-Blatchford score is a validated score that is easy to calculate based on simple clinical and biological variables that can identify patients with a low or a high risk of needing a therapeutic (interventional endoscopy, surgery and/ or transfusions).

AIM: To validate retrospectively the Glasgow-Blatchford Score (GBS).

METHODS: The study examined all patients admitted in both the general surgery department as of Anesthesiology of the Regional Hospital of Sidi Bouzid. There were 50 patients, which the mean age was 58 years and divided into 35 men and 15 women. In all these patients, we calculated the GBS. Series were divided into 2 groups, 26 cases received only medical treatment and 24 cases required transfusion and / or surgery. Univariate analysis was performed for comparison of these two groups then the ROC curve was used to identify the 'Cut off point' of GBS. Sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) with confidence interval 95% were calculated.

RESULTS: The SGB was significantly different between the two groups (p <0.0001). Using the ROC curve, it was determined that for the threshold of GBS ³ 7, Se = 96% (88-100%), Sp = 69% (51-87%), PPV = 74% (59 -90%) and NPV = 95% (85-100%). This threshold is interesting as to its VPN. Indeed, if GBS <7, we must opt for medical treatment to the risk of being wrong in only 5% of cases.

CONCLUSION: The Glasgow-Blatchford score is based on simple clinical and laboratory variables. It can recognize in the emergency department the cases that require medical treatment and those whose support could need blood transfusions and / or surgical treatment.

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