Effectiveness of the Oakland Score for Safe Discharge of Patients with Acute Lower Gastrointestinal Bleeding: A Validation Study

Abstract

Background: Acute lower gastrointestinal bleeding (LGIB) presents a significant challenge in emergency medicine, necessitating tools for effective risk stratification and management. The Oakland Score, developed to predict safe discharge and mortality in LGIB patients, offers potential utility but requires validation in diverse clinical settings. Material and Methods: This retrospective study analyzed 365 patients presenting with LGIB at Kartal Dr. Lütfi Kırdar City Hospital between January 1, 2021, and January 1, 2022. We evaluated the Oakland Score's effectiveness in predicting safe discharge and mortality, employing statistical analyses to determine the score's predictive accuracy and identify critical thresholds. Results: Among the study population, 60.27% presented with hematochezia, with a diverse age and gender distribution. Invasive procedures were performed in 42.47% of cases, and cardiovascular diseases were prevalent in 51.78%. The average Oakland Score was significantly lower for discharged patients (18.22) compared to those hospitalized (21.90), with a critical discharge threshold identified at a score of 16. The Oakland Score also demonstrated a sensitivity of 77% and specificity of 52.3% for predicting discharge outcomes, and a critical value of 24 for increased mortality risk, substantiating its predictive value. Conclusions: The Oakland Score effectively predicts safe discharge and mortality among LGIB patients in a Turkish hospital setting. With defined critical thresholds for clinical decision-making, it stands as a valuable tool for optimizing patient management and resource allocation in emergency departments.

Keywords

• Acute lower gastrointestinal bleeding
• Oakland Score
• Safe discharge
• Mortality