Objective The Glasgow-Blatchford Bleeding Score (GBS) was designed to identify patients with upper gastrointestinal bleeding (UGIB) who do not require hospitalisation. It may also help stratify patients unlikely to benefit from intensive care.Design We reviewed patients assigned a GBS in the emergency room (ER) via a semiautomated calculator. Patients with a score ≤7 (low risk) were directed to an unmonitored bed (UMB), while those with a score of ≥8 (high risk) were considered for MB placement. Conformity with guidelines and subsequent transfers to MB were reviewed, along with transfusion requirement, rebleeding, length of stay, need for intervention and death.Results Over 34 months, 1037 patients received a GBS in the ER. 745 had an UGIB. 235 (32%) of these patients had a GBS ≤7. 29 (12%) low-risk patients were admitted to MBs. Four low-risk patients admitted to UMB required transfer to MB within the first 48 hours. Low-risk patients admitted to UMBs were no more likely to die, rebleed, need transfusion or require more endoscopic, radiographic or surgical procedures than those admitted to MBs. No low-risk patient died from GIB. Patients with GBS ≥8 were more likely to rebleed, require transfusion and interventions to control bleeding but not to die.Conclusion A semiautomated GBS calculator can be incorporated into an ER workflow. Patients with a GBS ≤7 are unlikely to need MB care for UGIB. Further studies are warranted to determine an ideal scoring system for MB admission.

Introduction: Dengue infection is a common disease in tropical and subtropical regions and is characterized by fever, headache, arthralgia and joint and muscle pain.Occasionally, patients develop abdominal and gastrointestinal symptoms, however, little information exists regarding the occurrence of these events.Objective: The aim of this study was to determine the frequency of gastrointestinal signs and symptoms in a cohort of patients with Dengue fever.Material and Methods We performed a retrospective review of 1463 adult patients with a diagnosis of Dengue fever during the 2016 epidemic to determine the frequency of abdominal and gastrointestinal symptoms.All of the patients were attended in the Outpatient Department in a Public Hospital in Buenos Aires-Argentina Statistics Analysis: A descriptive statistic was performed using X2 test and Fisher `s exact test with a significance level of p<0.005.Results: Abdominal and gastrointestinal symptoms were present in 64% of patients.The most frequent symptoms was abdominal pain (n=1024,70%), followed by nausea (n= 877, 60%), vomiting (n=468, 32%), diarrhea (n=159, 17%), hepatomegaly (n=18,2%), gastrointestinal bleeding (n=9, 1%), splenomegaly (n=5, 0,5%) and ascites (n=1, 0,1%).Hospitalization was required in 99 patients (n=6,77%), all of them (100%) (p<0.00001) had some abdominal and gastrointestinal symptoms.In this group the most frequent symptoms were abdominal pain (n=99, 100%), followed by nausea (n=89, 90%), vomiting (n= 75, 76%), diarrhea (n=60, 61%), hepatomegaly (n=17, 18%), gastrointestinal bleeding (n= 9, 10%), splenomegaly (n=5, 5%) and ascites (n=1,1%) Conclusions: Our findings suggest a high frequency of gastrointestinal symptoms in patients with dengue fever.These symptoms were significantly more frequent in patients who were hospitalized, this suggests a relation of gastrointestinal symptoms with the severity of dengue infection and their presence should be considered by the decision-making health team for appropriate patients management.The differential diagnosis of an acute febrile syndrome with abdominal pain or gastrointestinal symptoms in patients living in endemic areas or who have recently travelled to certain regions should include dengue infection.

Upper GI bleeding is the most common GI cause for hospitalization in the US and costs over $5 billion/year. Numerous studies have tried to identify areas for cost reduction with varying success. Risk stratification using the Glasgow Blatchford Bleeding Score has identified low risk patients who could be treated as outpatients. We report the use of the GBBS to help direct bed assignment in a large urban hospital.

UGI bleeding is a frequent cause for hospitalization. Admission to ICU versus floor bed is usually based on subjective criteria. A more objective tool may help prevent errors in placement that delay needed care or waste resources. The Glasgow-Blatchford bleeding score (GBBS) has been shown to predict hospital mortality and the need for interventions in patients admitted with non-variceal UGI bleeding. Using the GBBS at admission may help stratify patients appropriate for floor care versus intermediate care (IMCU) or ICU.