Predictive value of the Glasgow-Blatchford Score in predicting clinical outcomes and intervention in patients with acute Lower GI Bleeding: experience of a Tunisian tertiary center

Aims Acute lower gastrointestinal bleeding (LGB) is a common medical emergency. Effective management relies on accurately identifying patients who need clinical interventions, such as endoscopic therapy, vascular embolization, surgery, or transfusion. While the Glasgow-Blatchford Score (GBS) is widely used to predict intervention needs in upper GI bleeding, its utility in acute lower GI bleeding has been less thoroughly evaluated. This study aims to assess the accuracy of the GBS in determining the necessity of clinical intervention in patients with acute LGB.

Methods This retrospective study, conducted from January 2022 to October 2024 at a tertiary university hospital, included patients presenting with acute LGB. The GBS was retrospectively calculated for each patient based on clinical report data. We assessed the GBS’s predictive accuracy for clinical intervention needs using the area under the receiver operating characteristic (AUROC) curve, sensitivity, specificity, and predictive values.

Results A total of 109 consecutive patients were included, with a median age of 72.5 years (range 22–91). Of these, 52 patients (47.7%) were over 70 years old, and 92 were men, resulting in a male-to-female sex ratio of 5.4. Six patients (5.5%) died, 22 (20.2%) experienced recurrent bleeding, 68 (62.4%) required transfusion, 12 (11%) received endoscopic therapy, and one (0.9%) underwent transcatheter arterial embolization. The GBS showed strong predictive accuracy for clinical intervention in acute lower GI bleeding, with an AUROC of 0.81 (95% CI: 0.72–0.85). At a threshold of GBS≥4, the score achieved a sensitivity of 88.4%, specificity of 87.9%, positive predictive value (PPV) of 90.5%, and negative predictive value (NPV) of 85.3%.

Conclusions In our study, the Glasgow-Blatchford Score demonstrated reliable predictive value in identifying patients with acute lower gastrointestinal bleeding who may require clinical intervention. With high sensitivity, specificity, and predictive values at a threshold of GBS≥4, the GBS is a valuable tool in acute care settings, supporting effective risk stratification and guiding clinical decision-making in the management of lower GI bleeding.

Publication History

Article published online:
27 March 2025