Glasgow-Blatchford score (pre-endoscopy): assesses likelihood patient will need intervention (score 0 = can manage as outpatient; score ≥1 = manage as inpatient).Takes into account haemoglobin, urea, SBP, sex, HR, presence of melaena, recent syncope, history of liver disease or heart failure (Blatchford et al. 2000).
Rockall score(post-endoscopy): mortality risk assessment (score ≤2 = good prognosis; score >8 = high mortality risk). Takes into account age, shock, comorbidities, diagnosis and evidence of bleeding (Rockall et al. 1996).
Preventing further bleeding
Treat the cause/reduce the risk of re-bleeding:
Carvedilol (β-blocker that reduces portal venous pressure)
Transjugular Intrahepatic PortoSystemic Shunt – allows blood to flow out of the portal system into a hepatic vein