For healthcare professionals
Glasgow-Blatchford score calculator
The Glasgow-Blatchford score (GBS) is a pre-endoscopy score for a patient with acute upper gastrointestinal bleeding. It adds points for blood urea, hemoglobin, systolic blood pressure, pulse, melena, syncope, hepatic disease and cardiac failure into a total from 0 to 23. It was built to predict the need for treatment such as transfusion, endoscopic therapy or surgery. It is written for clinicians and is not a diagnosis.
Admission values
For a patient presenting with acute upper gastrointestinal bleeding. Use the first values at presentation. Nothing you enter leaves this page.
What you will see
The Glasgow-Blatchford total from 0 to 23, the items that scored, and whether the total is at the low-risk threshold of 0 to 1.
Educational only, not medical advice. Not a diagnosis and not a treatment decision.
Source
Blatchford O and colleagues, Lancet 2000 (the original score). Items and points as printed in Table 1 of Gu and colleagues, 2018, and Table 1 of Orpen-Palmer and Stanley, 2023; blood urea nitrogen cut points in mg/dL from Table 1 of Bozkurt and colleagues, 2015 (all open access). The tests check every point value and every band boundary.
Validated in
Derived from 1748 patients admitted with upper gastrointestinal haemorrhage and prospectively validated in 197 patients (Blatchford 2000). It was externally validated at four UK sites in 2009 and has been studied widely in other countries, including an international multicentre study of 3012 patients (Orpen-Palmer and Stanley 2023).
Limits
Built to predict the need for treatment (transfusion, endoscopic therapy or surgery), not death: it was weaker than other scores at predicting 30-day mortality. Its specificity at the low-risk threshold is low, so some patients who could go home will still be admitted. It does not use endoscopic findings and does not replace clinical judgment.
Glasgow-Blatchford score items and points
The score uses values from admission (Blatchford 2000). Points as printed in the source tables (Gu 2018) (Orpen-Palmer 2023), with blood urea nitrogen in mg/dL from a third table (Bozkurt 2015):
| Admission marker | Value | Points |
|---|---|---|
| Blood urea | 6.5 to 7.9 mmol/L (BUN 18.2 to under 22.4 mg/dL) | 2 |
| 8.0 to 9.9 mmol/L (BUN 22.4 to under 28 mg/dL) | 3 | |
| 10.0 to 24.9 mmol/L (BUN 28 to under 70 mg/dL) | 4 | |
| 25 mmol/L or more (BUN 70 mg/dL or more) | 6 | |
| Hemoglobin, men | 12 to under 13 g/dL | 1 |
| 10 to under 12 g/dL | 3 | |
| Under 10 g/dL | 6 | |
| Hemoglobin, women | 10 to under 12 g/dL | 1 |
| Under 10 g/dL | 6 | |
| Systolic blood pressure | 100 to 109 mm Hg | 1 |
| 90 to 99 mm Hg | 2 | |
| Under 90 mm Hg | 3 | |
| Other markers | Pulse 100 per minute or more | 1 |
| Presentation with melena | 1 | |
| Presentation with syncope | 2 | |
| Hepatic disease | 2 | |
| Cardiac failure | 2 | |
| Maximum | 23 |
Values below the lowest band score 0: urea under 6.5 mmol/L (BUN under 18.2 mg/dL), hemoglobin 13 g/dL or more in men or 12 g/dL or more in women, and systolic pressure of 110 mm Hg or more. Hemoglobin in g/L is divided by 10 to give g/dL.
The low-risk threshold
A 2023 review reports that recent Asian-Pacific, European, American and international guidelines recommend a score of 1 or less as the threshold for low-risk patients who may be suitable for outpatient management (Orpen-Palmer 2023). In an international observational study of 2305 patients described in that review, cut points of 1 or less and 2 or less had higher specificity than a cut point of 0 (40% to 49% against 22%) with sensitivity of about 97%; because 3% of patients called low risk at 2 or less had adverse outcomes, the authors suggested 1 or less as the best cut point (Orpen-Palmer 2023).
There is no single published high-risk cut point. In the same international study, the best GBS threshold for predicting death was 5 or more (Orpen-Palmer 2023), and a 2018 study from Nanjing found an optimal cut point of 12 for in-hospital death (Gu 2018).
How well the score performs
- Original study: the score discriminated well, with a ROC curve area of 0.92, and was well calibrated for patients needing treatment (Blatchford 2000).
- Need for intervention or death: in an international multicentre study of 3012 patients, the GBS predicted the composite of hospital-based intervention or death best of the scores tested (AUROC 0.86) (Orpen-Palmer 2023).
- Transfusion: several studies found the GBS the most discriminating score for the need for blood transfusion, with an AUROC of 0.93 in a UK study of 1555 patients (Orpen-Palmer 2023).
- Mortality: the GBS was weaker at predicting 30-day mortality (AUROC 0.64 in the international study) than AIMS65 or the pre-endoscopy Rockall score (Orpen-Palmer 2023).
- Serious adverse events: a systematic review of 16 studies found the highest sensitivity for the GBS (0.98) among pre-endoscopic scores, but low specificity (0.16) (Orpen-Palmer 2023).
Local pathways and current guidelines should guide admission, timing of endoscopy and follow-up.
Related tools
Hepatic disease adds 2 points to the score. To grade liver function in cirrhosis, use the Child-Pugh score calculator; for end-stage liver disease, see the MELD score calculator. For other clinician scores on this site, see the qSOFA score calculator, the Glasgow Coma Scale calculator and the Alvarado score calculator for suspected appendicitis. For acute pancreatitis, see the Ranson criteria calculator.
Sources
- Blatchford O, Murray WR, Blatchford M. A risk score to predict need for treatment for upper-gastrointestinal haemorrhage. Lancet. 2000;356(9238):1318-1321. doi:10.1016/S0140-6736(00)02816-6. PMID 11073021. Abstract (derived in 1748 patients admitted with upper gastrointestinal haemorrhage, prospectively validated in 197 patients; ROC area 0.92). pubmed.ncbi.nlm.nih.gov/11073021/
- Gu L, Xu F, Yuan J. Comparison of AIMS65, Glasgow-Blatchford and Rockall scoring approaches in predicting the risk of in-hospital death among emergency hospitalized patients with upper gastrointestinal bleeding: a retrospective observational study in Nanjing, China. BMC Gastroenterol. 2018;18(1):98. doi:10.1186/s12876-018-0828-5. PMID 29954332. Open access (CC BY 4.0). Table 1 (Glasgow-Blatchford items and points, hemoglobin in g/dL). pmc.ncbi.nlm.nih.gov/articles/PMC6022417/
- Orpen-Palmer J, Stanley AJ. A Review of Risk Scores within Upper Gastrointestinal Bleeding. J Clin Med. 2023;12(11):3678. doi:10.3390/jcm12113678. PMID 37297873. Open access (CC BY). Table 1 (the Glasgow Blatchford score) and the sections on mortality, need for intervention, transfusion and low-risk patients. pmc.ncbi.nlm.nih.gov/articles/PMC10253886/
- Bozkurt S, Köse A, Arslan ED, et al. Validity of modified early warning, Glasgow Blatchford, and pre-endoscopic Rockall scores in predicting prognosis of patients presenting to emergency department with upper gastrointestinal bleeding. Scand J Trauma Resusc Emerg Med. 2015;23:109. doi:10.1186/s13049-015-0194-z. PMID 26714636. Open access (CC BY 4.0). Table 1 (Glasgow-Blatchford score with blood urea nitrogen in mg/dL). pmc.ncbi.nlm.nih.gov/articles/PMC4696211/
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-01. Spotted an error? See About.