Zhang DQ, Zhou Q, Li YF, Jia XY, Li X, Chen S, Lin K. Evaluating Glasgow-Blatchford score for fast-track emergency management of patients with acute upper gastrointestinal bleeding. World J Gastrointest Surg 2025; 17(9): 104997 [DOI: 10.4240/wjgs.v17.i9.104997]
Corresponding Author of This Article
Ke Lin, MD, PhD, Department of Emergency, University-Town Hospital of Chongqing Medical University, No. 55 Daxuecheng Middle Road, Shapingba District, Chongqing 401331, China. 800309@hospital.cqmu.ed
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Clinical Trials Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Sep 27, 2025; 17(9): 104997 Published online Sep 27, 2025. doi: 10.4240/wjgs.v17.i9.104997
Evaluating Glasgow-Blatchford score for fast-track emergency management of patients with acute upper gastrointestinal bleeding
Dong-Qing Zhang, Qin Zhou, Yun-Feng Li, Xin-Yu Jia, Xue Li, Shu Chen, Ke Lin
Dong-Qing Zhang, Department of Basic Courses, Chongqing Medical and Pharmaceutical College, Chongqing 401331, China
Qin Zhou, Yun-Feng Li, Xin-Yu Jia, Xue Li, Shu Chen, Ke Lin, Department of Emergency, University-Town Hospital of Chongqing Medical University, Chongqing 401331, China
Co-first authors: Dong-Qing Zhang and Qin Zhou.
Author contributions: Zhang DQ, Zhou Q and Lin K contributed to conception and design; drafting of the paper; Li YF and Jia XY contributed to analysis and interpretation of the data; Li X, Chen S contributed to correct data and revising it critically for intellectual content; and all authors read the complete manuscript and have approved submission of the paper; All authors agree to be accountable for all aspects of the work.
Supported by the Key Discipline of Pathology at Chongqing Medical and Pharmaceutical College, No. ygz2021303.
Institutional review board statement: This study was approved by the Ethics Committee of the University-Town Hospital of Chongqing Medical University (Approval No. LL-202275).
Clinical trial registration statement: This study is registered at Chinese Clinical Trial Registry. The registration identification number is ChiCTR2400080002 (Date of Registration: 2024-01-18).
Informed consent statement: Informe consent was waived by the Ethics Committee of University-Town Hospital of Chongqing Medical University due to the retrospective design of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request at 800309@hospital.cqmu.ed.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ke Lin, MD, PhD, Department of Emergency, University-Town Hospital of Chongqing Medical University, No. 55 Daxuecheng Middle Road, Shapingba District, Chongqing 401331, China. 800309@hospital.cqmu.ed
Received: January 9, 2025 Revised: April 9, 2025 Accepted: July 28, 2025 Published online: September 27, 2025 Processing time: 259 Days and 5.2 Hours
Abstract
BACKGROUND
Acute upper gastrointestinal bleeding (AUGIB) is a common emergency critical illness that requires prompt assessment upon admission to prevent disease deterioration. As a resuscitation mode, the fast track for emergency treatment increases the success rate and improves patient outcomes. However, misuse will consume resources. The Glasgow-Blatchford score (GBS) is considered to predict the clinical intervention needs for AUGIB patients, guiding diagnosis and treatment. Therefore, clinical research is needed to identify the recommended GBS thresholds that support effective use in AUGIB patients.
AIM
To validate the effectiveness of the GBS in establishing a fast track to reduce the time and cost of treatment for patients with AUGIB.
METHODS
A retrospective analysis was performed using the data of 124 cases of AUGIB patients with GBS ≥ 6 treated at the University-Town Hospital of Chongqing Medical University from August 2020 to April 2023. Based on GBS risk stratification, patients were divided into moderate-risk (12 > GBS ≥ 6) and high-risk (GBS ≥ 12) groups. Furthermore, depending on whether a fast track was established after the patients arrived in the emergency department, the patients were categorized into control and fast-track groups. The changes in various indicators, such as length of time in the emergency resuscitation room, door-to-endoscopy time, total blood transfusion volume, hospitalization duration, and hospitalization costs, were compared between the control and fast-track groups under each risk stratification level.
RESULTS
In the comparison of the aforementioned indicators, the moderate-risk fast-track group did not show any significant differences from the control group (P > 0.05). However, in the high-risk fast-track group, the door-to-endoscopy time, total blood transfusion volume, and hospitalization costs were significantly lower than those in the control group (P < 0.05).
CONCLUSION
Establishing a fast track for emergency treatment based on GBS risk stratification has assessment value in reducing door-to-endoscopy time, decreasing total blood transfusion volume, and lowering hospitalization costs in patients with AUGIB. GBS ≥ 12 is recommended as the threshold for implementing the fast track for emergency treatment, and its clinical promotion is advised.
Core Tip: This study analyzed data from 124 patients with acute upper gastrointestinal bleeding with Glasgow-Blatchford score (GBS) ≥ 6. Based on GBS, patients were divided into moderate- and high-risk groups. Further categorization was done into control and fast track groups based on whether a fast track was established. Comparisons were made for stay times, door-to-endoscopy time, blood transfusions, hospitalization, and costs between groups at each risk level. Notably, the implementation of the emergency treatment fast track for patients with GBS ≥ 12 demonstrated significant advantages over traditional treatment models. Therefore, we identified GBS ≥ 12 as the threshold for implementing the fast track protocol.
