Diagnostic utility of the Glasgow-Blatchford score in predicting rebleeding in upper gastrointestinal bleeding: a tertiary care study

Glasgow-Blatchford score in predicting upper GI rebleeding

Abstract

Objective: This study was conducted to ascertain the Glasgow-Blatchford bleeding score's diagnostic accuracy in upper GI bleeding patients as risk stratification tool for rebleeding.

Study design: Cross-sectional observational study.

Place and duration of study: The study was conducted at Medical unit DHQ Hospital, Rawalpindi from 7th August 2022 to 7th February 2023 after ethical approval.

Patients and Methods: A total of 165 patients of both genders, aged 20 to 50 years presenting with upper GI bleeding were included and written informed consent was taken. Patients having pre-existing bleeding disorder, anticoagulants or antiplatelets use, history of corrosive intake, traumatic GI bleed cases were excluded. The Glasgow Blatchford score (GBS) was calculated and cut off value >3 was taken as a risk factor for rebleed. Data were analyzed using SPSS-22, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPPV) for GBS > 3 were calculated. Diagnostic accuracy of Blatchford score was calculated as risk stratification tool for rebleeding.

Results: Amongst 165 patients, mean age was 39.4 ± 5.8 years. There were 73(44.2%) females and 92(55.8%) males. There was upper GI rebleed in 32(24.2%) cases. Study found 80% sensitivity and 92% specificity of Glasgow Blatchford (GBS) score to predict the rebleed. The positive predictive value (PPV) was 76.2% and negative predictive value (NPPV) was 93.5%. GBS was 89.09% accurate in diagnosing the rebleed. Age group data stratification was substantial (p-value <0.001). There was a substantial gender-based data stratification (p-value <0.01). Significant data stratification was found for the duration of symptoms (p<0.001).

Conclusion: Glasgow Blatchford score is a sensitive and specific score for predicting risk of rebleeding in patients of upper GI bleed demonstrating high sensitivity, specificity and diagnostic accuracy. GBS score should be used to identify the emergency room patients at risk of rebleeding.