What is modified Blatchford score?


Modified Blatchford score

Modified Blatchford score is used for risk stratification in acute upper gastrointestinal bleeding. This score can be calculated at the bedside. The advantage of the Blatchford score is that it may be used before endoscopy to predict the need for intervention to treat bleeding.

Followings are the admission markers along with respective score value:

Blood urea:
≥25 mmol/L (70 mg/dL): 6
10-25 mmol/L (28-70 mg/dL): 4
8-10 mmol/L (22.4-28 mg/dL): 3
6.5-8 mmol/L (18.2-22.4 mg/dL): 2
<6.5 mmol/L (18.2 mg/dL): 0

Hemoglobin for Men:
< 100 g/L (10g/dL): 6
100-119 g/L (10- 11.9 g/dL): 3
120- 120 g/L (12-12.9 g/dL): 1
130 g/L (13 g/dl): 0

Hemoglobin for women:
< 100 g/L (10g/dL): 6
100-119 g/L (10- 11.9 g/dL): 1
≥120 g/L (12 g/dl): 0

Systolic blood pressure:
<90 mmHg: 3
90-99 mmHg: 2
100-109 mmHg: 1
>109 mmHg: 0

Other markers:
Presentation with syncope: 2
Hepatic disease: 2
Cardiac failure: 2
Pulse 100 beats/min: 1
Presentation with melena: 1
None of the above: 0

Low scores (2 or less) are associated with a very low risk of adverse outcome. Higher the score, higher risk to the patient.

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