P1531 - The Glasgow Blatchford Score (GBS) Is Associated With the Need for Endoscopic Intervention and Blood Transfusion in Patients With Upper Gastrointestinal Bleeding

Monday, October 25, 2021

10:30 AM – 4:15 PM PT

Location: Shoreline Exhibit Hall

Has Audio

Presenting Author(s)

Alexandra Davies, DO

McLaren Macomb Medical Center
Mount Clemens, MI, United States

Alexandra Davies, DO, Hind Neamah, MD, MPH, Anthony Teta, MD, Grace Brennan, PhD, Bruce Kovan, DO
McLaren Macomb Medical Center, Mount Clemens, MI

Introduction: At an incidence of 48-160/100,000 individuals, upper gastrointestinal bleeding (UGIB) is the most common gastroenterological emergency, in the United States, accounting for 300,000 hospitalizations and $3.3 billion in healthcare spending, yearly. GBS, a quick tool that uses non-endoscopic criteria for clinical stratification of UGIB, allows for early diagnosis and outcome prediction, including need for intervention. The goals of this study are to determine the GBS scores of patients who underwent esophagogastroduodenoscopy (EGD) and if the need for endoscopic intervention and blood transfusion are related to GBS in patients with UGIB.

Methods: This is a cross-sectional retrospective study that included patients ≥18 years, who were admitted for UGIB to McLaren Macomb Medical Center (MMMC) and underwent EGD between July, 2018 and July, 2020. The patient encounters of interest were identified using international classification of disease (ICD 10) procedure codes for EGD. Demographics and the need for intervention or blood transfusion, variables comprising GBS, and other explanatory variables were extracted.

Frequencies, percentages, and student T-test were used when appropriate. A stepwise regression analysis was performed to determine predictors of GBS. SPSS version 25 was used to analyze the data. Statistical significance was set at a p< 0.05.

Results: A total of 130 observations were included in this analysis. No patients were noted to have a GBS ≤2, indicating successful evidence-based allocation of resources, as a GBS ≤1 to ≤2 is associated with safe outpatient management. We found that GBS was statistically significantly related to the need for intervention, blood transfusion, and age group. Additionally, those who needed intervention and blood transfusion scored 1.493 [mean GBS 13.13±3.28 versus 10.62±3.83 (P=0.004)] and 3.486 [mean GBS 13.12±2.68 versus 9.16±3.83 (P=0.000)] higher, respectively. Also, those who are ≤60 years-old scored 1.77 [mean GBS 9.38±4.11 versus 11.7±3.57 (P=0.002)] less.

Discussion: Our study is among a few that investigated and found a mean GBS associated with need for intervention and blood transfusion. Even at higher GBS, we may be able to further stratify patients’ risk and predict need for intervention and blood transfusion. Further research is needed to investigate this nuance.

Variable	Frequency	Percentage	GBS Mean	ΔMean GBS	CI	P
Hemostatic Intervention
Yes	24	17.8	13.13 (3.28)	1.493	(0.034, 2.951)	0.004
No	111	82.2	10.62 (3.83)
Blood Transfusion
Yes	65	48.1	13.12 (2.68)	3.486	(2.36, 4.62)	0.000
No	70	51.9	9.16 (3.80)
Age Group
≤ 60	37	27.4	9.38 (4.11)	-1.77	(-2.91, -0.431)	0.002
≥ 60	98	72.6	11.70 (3.57)

Table: Table1: GBS Mean Scores Associated With Need for Hemostatic Intervention

Disclosures:

Alexandra Davies indicated no relevant financial relationships.

Hind Neamah indicated no relevant financial relationships.

Anthony Teta indicated no relevant financial relationships.

Grace Brennan indicated no relevant financial relationships.

Bruce Kovan indicated no relevant financial relationships.

Alexandra Davies, DO, Hind Neamah, MD, MPH, Anthony Teta, MD, Grace Brennan, PhD, Bruce Kovan, DO. P1531 - The Glasgow Blatchford Score (GBS) Is Associated With the Need for Endoscopic Intervention and Blood Transfusion in Patients With Upper Gastrointestinal Bleeding, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.