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    Oakland Score for Safe Discharge After Lower GI Bleed

    Predicts readmission risk in patients with acute lower GI bleeding.
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    INSTRUCTIONS

    Use in patients presenting with lower GI bleed (urgent, emergent, or primary care setting) to help determine if outpatient management is feasible.

    When to Use

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    <40
    0
    40-69
    +1
    ≥70
    +2
    Female
    0
    Male
    +1
    No
    0
    Yes
    +1
    No blood
    0
    Blood
    +1
    <70
    0
    70-89
    +1
    90-109
    +2
    ≥110
    +3
    50-89
    +5
    90-119
    +4
    120-129
    +3
    130-159
    +2
    ≥160
    0
    3.6-6.9 (36-69)
    +22
    7.0-8.9 (70-89)
    +17
    9.0-10.9 (90-109)
    +13
    11.0-12.9 (110-129)
    +8
    13.0-15.9 (130-159)
    +4
    ≥16.0 (160)
    0

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

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    Formula

    Addition of the selected points:

    Variable

    Points

    Age, years

    <40

    0

    40-69

    1

    ≥70

    2

    Sex

    Female

    0

    Male

    1

    Previous lower GI bleeding admission

    No

    0

    Yes

    1

    DRE findings

    No blood

    0

    Blood

    1

    Heart rate, bpm

    <70

    0

    70-89

    1

    90-109

    2

    ≥110

    3

    Systolic blood pressure, mmHg

    50-89

    5

    90-119

    4

    120-129

    3

    130-159

    2

    ≥160

    0

    Hemoglobin, mg/dL (g/dL)

    3.6-6.9 (36-69)

    22

    7.0-8.9 (70-89)

    17

    9.0-10.9 (90-109)

    13

    11.0-12.9 (110-129)

    8

    13.0-15.9 (130-159)

    4

    ≥16.0 (160)

    0

    Facts & Figures

    Interpretation:

    Score

    Probability of safe discharge*

    Recommendation**

    0-2

    99%

    Consider discharge, with appropriate precautions

    3-4

    98%

    5

    97%

    6-7

    96%

    8

    95%

    9

    93%

    Admission with further workup and resuscitation as necessary

    10

    91%

    11

    89%

    12-13

    87-89%

    14-15

    77-81%

    16-17

    67-72%

    18-20

    50-62%

    21-23

    33-45%

    24-26

    20-28%

    27-29

    11-16%

    ≥30

    0-1%

    *Defined as absence of rebleeding, blood transfusion, therapeutic intervention, 28 day readmission, or death.

    **From Cañamares 2017.

    Dr. Kathryn A. Oakland

    About the Creator

    Kathryn A. Oakland, MD, MBBS, is a surgeon at the Princess Grace Hospital in London, United Kingdom. She is also the chief medical officer clinical management fellow for HCA Healthcare in London. Dr. Oakland’s research focuses primarily on gastrointestinal bleeding.

    To view Dr. Kathryn A. Oakland's publications, visit PubMed