Photo Credit: Mohammed Haneefa Nizamudeen
The following is a summary of “Oakland score to identify low-risk patients with lower gastrointestinal bleeding performs well among emergency department patients,” published in the February 2025 issue of Emergency Medicine by DiLena et al.
The Oakland Score, designed to predict 30-day adverse events (AEs) in patients hospitalized with lower gastrointestinal bleeding (LGIB) and potentially identify candidates for safe discharge, had not yet been evaluated in the emergency department (ED) setting.
Researchers conducted a retrospective study to investigate the Oakland Score’s ability to predict adverse outcomes in individuals with LGIB who presented to the ED.
They assessed adults (≥ 18 years old) with a primary ED diagnosis of LGIB across 21 EDs from March 1, 2018, to March 1, 2020 and excluded those likely to have upper gastrointestinal bleeding (esophago-gastroduodenoscopy without LGIB evaluation), those who left against medical advice or before provider evaluation, individuals without active health plan membership, and those with incomplete Oakland Score data. Predictive accuracy was estimated using the area under the receiver operator curve (AUROC), sensitivity, specificity, positive and negative predictive values, and likelihood ratios at various clinically relevant thresholds.
The results showed 8,283 individuals with LGIB; 52% were female, with a mean age of 68 years; 49% were non-White, and 27% experienced an AE. The AUROC for predicting AEs was 0.85 (95% CI 0.84–0.86). Among 1,358 individuals with an Oakland Score of ≤ 8, 4.9% had an AE, with a sensitivity of 97% (95% CI 96%−98%).
Investigators concluded that the Oakland Score demonstrated strong predictive accuracy for patients with LGIB in the ED, but further prospective study was needed to determine its impact on clinical decisions, patient outcomes, and resource allocation.
Source: intjem.biomedcentral.com/articles/10.1186/s12245-025-00815-5
