The Glasgow-Blatchford Score (GBS) is used in upper GI bleeding to predict the need for intervention. Which patient can be safely considered for outpatient management?

• A GBS of 5 with active melaena and haemodynamic compromise
• B GBS of 3 with haematemesis and liver cirrhosis
• C Any GBS score in a patient on warfarin with melaena
• D GBS of 0: Hb >130 g/L (male), no melaena, no syncope, no hepatic disease, BUN ≤18 mg/dL, no tachycardia ✓

Explanation

A GBS of 0 identifies low-risk upper GI bleed patients who have a very low probability of requiring endoscopic intervention, blood transfusion, or surgery, and who can safely be discharged for outpatient endoscopy. The score incorporates blood urea, haemoglobin, systolic BP, pulse rate, presence of melaena/syncope, and comorbidities (hepatic disease, cardiac failure). A GBS ≥1 warrants admission and early endoscopy. Patients with active haemodynamic compromise, melaena, or cirrhosis clearly require admission regardless of score.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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