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Original Research

RMJ. 2016; 41(4): 394-397


Diagnostic accuracy of high risk Glasgow Blatchford score and need for endoscopic intervention in upper gastrointestinal bleeding

Saba Samreen, Muhammad Khurram.

Abstract
Objective: To determine the diagnostic accuracy of high risk Glasgow Blatchford Score (GBS) in investigating the need for endoscopic intervention in upper gastrointestinal bleeding (UGIB).
Methodology: This Cross-section validation study was carried out at Department of Medicine Holy Family Hospital, Rawalpindi, Pakistan from August 1, 2014 till January 31,2015. Patients with UGIB were stratified according to GBS.
Results: Out of 280 patients, there were 172 (61.4%) males and 108 (38.6%) females. The mean age was 50yrs (range 16-85yrs). Patients with stigmata of bleeding who underwent intervention were 173 (61.8%) and 107 (38.2%) patients did not have any endoscopic intervention. The median GBS score was 9 (range 0-20). The median GBS score was 11 in patients with endoscopic intervention and 5 in patients without endoscopic intervention. Patients classified as high risk (GBS ≥ 3) for UGIB were 229 (81.8%) and low risk patients (GBS < 3) were 51 (18.2%). The diagnostic accuracy of high risk GBS for identifying patients with UGIB in need for endoscopic intervention is as follows: sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate was computed as 93.64%, 37.38%, 70.74% , 78.43% and 72%, respectively.
Conclusion: The diagnostic accuracy of high risk Glasgow Blatchford Score in determining the need for endoscopic intervention in UGIB is higher while the specificity still needs improvement.

Key words: Upper gastrointestinal bleeding, endoscopic intervention, Glasgow Blatchford Score.



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