MDCalc » Hematology/Oncology

Glasgow-Blatchford Bleeding Score (GBS)

admin — Thu, 08 Oct 2009 03:34:18 +0000

Glasgow-Blatchford Score

Blood Urea
≥6·5 <8·0	2
≥8·0 <10·0	3
≥10·0 <25·0	4
≥25	6
Hemoglobin (g/L) for men
≥12.0 <13.0	1
≥10.0 <12.0	3
<10.0	6
Hemoglobin (g/L) for women
≥10.0 <12.0	1
<10.0	6
Systolic blood pressure (mm Hg)
100–109	1
90–99	2
<90	3
Pulse ≥100 (per min)	1
Presentation with melaena	1
Presentation with syncope	2
Hepatic disease	2
Cardiac failure	2

Low risk = Score of 0. Any score higher than 0 is "high risk" for needing a medical intervention of transfusion, endoscopy, or surgery.

admin — Sat, 28 Feb 2009 14:44:33 +0000

admin — Fri, 02 Jan 2009 04:35:11 +0000

admin — Fri, 02 Jan 2009 03:28:56 +0000

Absolute Reticulocyte Count = # or % retics * (Pt's Hct / Normal Hct)
Reticulocyte Index = Absolute Retic Ct / Maturation Factor

Maturation Factors:

Retic Index > 2% = adequate response; < 2% = hypoproliferation

admin — Fri, 02 Jan 2009 03:26:08 +0000

Absolute Neutrophil Count = 10 * WBC count in 1000s * (% PMNs + % Bands)

Neutropenia: ANC < 1500 cells / mm³

Filgrastim (Neupogen), aka G-CSF, can stimulate production of neutrophils.

Is patient female?	Yes
Hemoglobin	g/dL
BUN	mg/dL
Initial Systolic Blood Pressure	mm Hg
Heart Rate ≥ 100	Yes
Does the patient have melena?	Yes
Did the patient have syncope?	Yes
Does the patient have hepatic disease?	Yes
Does the patient have heart failure?	Yes
Score	points

Active cancer?	Yes +1
Bedridden recently >3 days or major surgery within four weeks?	Yes +1
Calf swelling >3cm compared to the other leg?	Yes +1
Collateral (nonvaricose) superficial veins present?	Yes +1
Entire leg swollen?	Yes +1
Localized tenderness along the deep venous system?	Yes +1
Pitting edema, greater in the symptomatic leg?	Yes +1
Paralysis, paresis, or recent plaster immobilization of the lower extremity	Yes +1
Alternative diagnosis to DVT as likely or more likely?	Yes -2
Score	Points

Clinical Signs and Symptoms of DVT?	Yes +3
PE Is #1 Diagnosis, or Equally Likely	Yes +3
Heart Rate > 100?	Yes +1.5
Immobilization at least 3 days, or Surgery in the Previous 4 weeks	Yes +1.5
Previous, objectively diagnosed PE or DVT?	Yes +1.5
Hemoptysis?	Yes +1
Malignancy w/ Treatment within 6 mo, or palliative?	Yes +1
Score

Percentage Neutrophils	%
Percentage Bands	%
WBC (per 1000. Usually reported as "8.4"; do not enter 8400.)	cells/ml
Absolute Neutrophil Count	cells/ml

Percentage or # Retics	%
Pt's Hct
Normal Hct (depends on sex and lab norm)
Absolute Reticulocyte Count
Reticulocyte Index