Predictive value of clinical risk scores for adverse outcomes and safe discharge in acute lower gastrointestinal bleeding
American Journal of Emergency Medicine, cilt.99, ss.370-375, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 99
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.ajem.2025.10.051
- Dergi Adı: American Journal of Emergency Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.370-375
- Anahtar Kelimeler: Lower gastrointestinal bleeding, Clinical prediction tools, Adverse outcomes, Safe discharge, Scoring systems, Scoring systems
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: This study aims to evaluate the predictive value of various clinical prediction tools in predicting adverse outcomes and safe discharge in patients with lower gastrointestinal bleeding (LGIB). Methods: This retrospective cohort study was conducted in the emergency department of a tertiary training and research hospital between October 1, 2017, and October 1, 2022. Adult patients (≥18 years) with a final diagnosis of acute LGIB were included. Demographics, medication history, chief complaints, vital signs, physical examination findings, laboratory results, bleeding sources, adverse outcomes (in-hospital mortality, severe bleeding, transfusion needs, and therapeutic interventions), and the variables needed to calculate the CHAMPS, NOBLADS, Oakland, SALGIB, and Strate scores were recorded, and analysis was performed. Results: A total of 2051 patients were included in the final analysis. The median age of the patients was 59 years (IQR: 42–75), and 40.7 % were female. An adverse outcome occurred in 792 (38.6 %) patients, and severe bleeding occurred in 611 patients (29.8 %). A total of 752 patients (36.7 %) required blood transfusions, and 67 patients (3.3 %) underwent therapeutic intervention. The Oakland score demonstrated the highest predictive performance for adverse outcomes (AUC: 0.902), severe bleeding (AUC: 0.925), and safe discharge (AUC: 0.889). The SALGIB score followed, with AUC values of 0.880, 0.901, and 0.867, respectively, for the same outcomes. The remaining scores exhibited moderate predictive performance across all three outcomes. Conclusion: The Oakland and SALGIB scores outperformed other clinical prediction tools and may aid clinicians in identifying patients at risk of adverse outcomes and making safe discharge decisions in acute LGIB.