Aoki et al developed a risk score for evaluating a patient with acute lower gastrointestinal bleeding. This can help to identify a patient who may require more aggressive management. The authors are from multiple institutions in Japan.
Patient selection: acute lower gastrointestinal bleeding
Acronym: NOBLADS
Independent predictors of severe lower gastrointestinal bleeding:
(1) nonsteroidal anti-inflammatory drug use
(2) no diarrhea,
(3) no abdominal tenderness
(4) systolic blood pressure <= 100 mm Hg
(5) nonaspirin antiplatelet drug
(6) serum albumin < 3.0 gdL
(7) Charlson comorbidity disease scores >= 2
(8) syncope
total score =
= SUM(points for parameters present(
Interpretation:
• minimum score: 0
• maximum score: 8
• A score >= 5 is associated with severe lower GI bleeding.
• The need for transfusion increased as the score increased.
Performance:
• The area under the ROC curve is 0.77.
