Oakland et al reported a simple score for evaluating a patient undergoing lower gastrointestinal bleeding. This can help to distinguish minor and major bleeds. The authors are from multiple institutions in England and Canada.
Patient selection: lower gastrointestinal bleeding (LGIB)
Parameters:
(1) age in years
(2) gender
(3) previous lower GI bleed admission
(4) blood present on digital rectal exam (DRE)
(5) heart rate in beats per minute
(6) systolic blood pressure in mm Hg
(7) hemoglobin in g/L
Parameter
Finding
Points
age in years
< 40 years of age
0
40 to 69
1
>= 70
2
gender
female
male
previous lower GI bleed admission
no
yes
blood on DRE
heart rate
< 70 beats per minute
70 to 89
90 to 109
>= 110
3
systolic blood pressure
< 90 mm Hg
5
90 to 119
4
120 to 129
130 to 159
>= 160
hemoglobin
< 70
22
17
13
110 to 129
8
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 35
• A score <= 8 is considered low risk and the patient can be discharged if there are no other indications for hospital admission.
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Specialty: Gastroenterology
