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Glasgow leads the world on bleeding treatment

Tuesday, January 31, 2017

Glasgow is leading the world on managing patients with upper gastrointestinal bleeding, according to a new study published in the British Medical Journal. 

The international study found that a scoring system developed in Glasgow to identify which patients need to be admitted to hospital following an upper gastrointestinal (GI) bleed was the best way to assess and manage these patients around the world.

The Glasgow Blatchford Score (GBS) was developed by a now retired Glasgow Public Health Consultant, Dr Oliver Blatchford in 2000 and is already being used in hospitals around the world including the USA, Europe, New Zealand and Singapore. The GBS looks at a patient’s description of symptoms, pulse and blood pressure, as well as two blood tests which are available in the first hour after they attend hospital.

Lead researcher and author of the BMJ article, Consultant Gastroenterologist Dr Adrian Stanley of Glasgow Royal Infirmary explained: “It is common for patients to present to our Emergency Departments with upper GI bleeding, resulting from stomach ulcers or bleeding vessels in the GI tract. Calculating their GBS on presentation allows us to target our management of these patients better. We can identify those at very low risk of poor outcome who don’t need to be admitted to hospital, allowing us to focus on the more seriously ill patients who need to be admitted for transfusion and urgent endoscopy.

“We carried out a 12 month study into the effectiveness of five risk scoring systems, looking at more than 3,000 patients presenting to six large international hospitals – the largest prospective study of this condition ever undertaken. We found that out of the five risk scores we compared, the Glasgow Blatchford Score (GBS) was superior to the English, Italian and American risk scores in their ability to predict need for hospital based intervention and survival in this common medical emergency.

Recent UK, European and American guidelines have recommended the use of GBS for patients with this condition. This study identifies the optimum score threshold to categorise patients into low and high risk and confirms the superiority of GBS to other scores across all international sites. It also confirms that more patients can be identified as low-risk and therefore avoid hospital admission.

Dr Stanley said: “This is an example of Glasgow clinical research changing practice internationally and is a development which will be of benefit to many patients around the world.”

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