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Glasgow Study to Save Thousands of Hospital Admissions and Millions of Pounds

December 15, 2008 3:52 PM

A revolutionary new technique developed by Glasgow doctors could save the NHS millions of pounds and could help reduce needless hospital admissions all over the world.

The new Glasgow Blatchford Scale (GBS) is a clinical scoring system to determine the severity of internal bleeding.

In the UK more than 51,000 people attend hospital with symptoms of internal bleeding each year and are usually admitted before doctors can determine the severity of their condition and treat them. The GBS has shown that many of those admissions are unnecessary and found that 22% of patients with internal bleeding can be safely treated as outpatients instead.

It is estimated that the scoring system could save between 60,000 to 100,000 hospital bed days every year in UK hospitals and experts have calculated that it could save the NHS £13.6million per year.

If the GBS is adopted by other UK and international hospitals it could be as famous as the world renowned Glasgow Coma Scale (a simple measurement developed in Glasgow in 1974 and now used around the world to record the conscious state of a person).

Dr Adrian Stanley, Consultant Gastroenterologist at Glasgow Royal Infirmary, led the study and worked with colleagues in Glasgow, Dundee, Stockton and Truro.

Dr Stanley explained: “Internal bleeding, also known as upper gastrointestinal haemorrhage (UGIH) is a very common reason for hospital admission, particularly in the West of Scotland. It can range from vomiting small amounts of blood to major bleeding. Traditionally the vast majority of patients would be admitted and may undergo an endoscopy (use of a thin fibre optic camera to see into the stomach) with or without further intervention if needed. However the new scoring system is able to identify a low-risk group who do not require hospital admission or treatment but instead could come for an out-patient endoscopy at a later stage.”

Dr Stanley and his colleagues put initial work by Dr Oliver Blatchford, a Glasgow based Consultant Epidemiologist working in NHS Health Protection Scotland, to the practical test in a study which involved 676 patients across the UK.

Dr Blatchford developed the test more than ten years ago. He said "In modern medical practice doctors don’t have the time or resources to admit people in the huge numbers they did 40 years ago. They want to take decisions quickly, and this is what the scoring system allows them to do."

Each patient was checked using the new GBS, to assess who was low-risk and did not need to stay in hospital for observation, exploratory tests, transfusions, invasive treatment or surgery. The GBS uses a combination of the patient’s history, examination and laboratory tests. When put into practice it found that 22% of patients presenting with UGIH did not require admission and these patients were asked to come back for outpatient endoscopy, apart from a small group who were admitted for unrelated conditions.

Dr Stanley added: “Most patients would rather avoid coming into hospital unless absolutely necessary, but accurate identification of patients who do not require in-patient management is critical. With the GBS, patients can be assessed quickly and accurately in A&E. Our data suggests that if the GBS was extended to all UK hospitals, up to 100 000 “bed-days” for could be avoided for this condition each year. This would allow us to focus our resources and skills on those patients with more severe bleeding and other conditions who definitely do require inpatient admission. We hope the GBS will now be evaluated in other hospitals in the UK and around the world.”

ENDS

Notes for news editor:

The GBS study spanned 12 months and involved Glasgow Royal Infirmary, Ninewells Hospital in Dundee, Royal Cornwall Hospital in Truro, and University Hospital of North-Tees in Stockton.

If you would like to interview Dr Stanley please contact the Press Office on 0141 201 4429.

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