Background: Patients with upper gastrointestinal bleeding (UGIB) are usually admitted to hospital due to a lack of standardized risk stratification protocol for determining the severity of bleeding. There are several risk scores for risk stratification in UGIB patients. The Blatchford score, which relies only on clinical and laboratory parameters, is practical in the emergency setting. However,  appropriate cut points of the Blatchford score have not been identified yet.
Objective: This study aims to determine the validity of the Blatchford score to predict necessary endoscopic treatment of patients with upper gastrointest nal bleeding in the Emergency Department at Songklanagarind Hospital.
Materials and methods: This is a prospective observational study on patients aged 16 years and older who presented in Songklanagarind Hospital Emergency Department from 1 January 2008 to 31 December 2009 and finally diagnosed with upper gastrointestinal bleeding. Blatchford scores were calculated for each enrolled patient. Endoscopic treatment was noted as the end point of this study to determine the validity of the Blatchford score at each point in the scoring system.
Results: There were 240 patients enrolled including 193 (80.4%) men. The mean Blatchford score was 10.6±4.1. Two hundred and four patients underwent endoscopy which was necessary for 116 (56.9%) patients and 11 patients who did not require endoscopic treatment had a Blatchford score of less than 3. The negative predictive value of those 11 patients was 100%.
Conclusion: The Blatchford score can be used for initial risk stratification in upper gastrointestinal bleeding in the emergency setting. The data show that the patients who had Blatchford scores less than 3 did not require endoscopic treatment.