Assessment of the Prognostic Performance of the Oakland Score in Lower Gastrointestinal Bleeding: A Retrospective Cohort Study.
Oakland Score best discriminates need for intensive care unit admission in lower gastrointestinal bleeding
Assessment of the Prognostic Performance of the Oakland Score in Lower Gastrointestinal Bleeding: A Retrospective Cohort Study.
Lower gastrointestinal bleeding (lower gastrointestinal bleeding) is a common and potentially life-threatening emergency that disproportionately affects elderly, comorbid patients, yet evidence-based risk stratification tools remain underused.
This study aimed to determine prognostic factors in patients presenting with lower gastrointestinal bleeding and to evaluate the relationship between the Oakland Score and adverse clinical outcomes.
In this single-centre, retrospective, descriptive study, patients aged 18 years and older who presented to the emergency department with lower gastrointestinal bleeding between 2015 and 2024, and who were evaluated, treated and followed up by the Department of Gastroenterology at Dokuz Eylül University, and who underwent endoscopic evaluation were reviewed.
higher score more strongly predicts intensive care unit admission, 1.0 would be perfect
The mean age was 69.8 ± 15.6 years, and 50.4% of patients were female.
Red blood cell transfusion was required in 52.8% of patients, and the in-hospital mortality rate was 6.1%.
The Oakland Score was significantly associated with mortality, intensive care unit admission, blood-product transfusion, early and late rebleeding, and emergency surgery (all p < 0.05).
On multivariable logistic regression, the Oakland Score was an independent predictor of one-month rebleeding (OR 1.082; 95% CI 1.032-1.133; p = 0.001) but did not retain independent significance for mortality or intensive care unit admission after adjustment for malignancy, serum albumin and BUN.
The Oakland Score is significantly associated with major adverse outcomes in lower gastrointestinal bleeding and is particularly sensitive for predicting mortality and intensive care unit admission.
It is a useful adjunct to clinical judgement for risk stratification, although it should be interpreted alongside the patient's overall clinical status.