Lower Digestive Hemorrhagic Syndrome. Scoring Systems

Authors

  • Anton Svirchev First University Hospital, Sofia Author
  • Krasimir Vasilev First University Hospital, Sofia Author
  • Georgi Gurbev First University Hospital, Sofia Author

DOI:

https://doi.org/10.14748/epn62t66

Keywords:

hemorrhage, lower gastrointestinal tract, scoring systems, risk assessment, Oakland score

Abstract

Surgical and gastroenterological diseases affecting the lower gastrointestinal tract cause a number of complications, one of which is hemorrhage. Despite the possibility of self-limitation, bleeding can be fatal, which outlines it as a serious medico-social problem. Correct assessment of the patient's condition and the need for hospitalization is of key importance for increasing the level of the proposed diagnostics and therapy, as well as in economic terms. The above-described problems lead to the development of a large number of assessment systems aimed at determining the risk among patients with hemorrhage from the lower gastrointestinal tract. One of the current scoring systems is the Oakland scoring system, characterized by maximally simplified steps and suitable for determining patients who do not need hospitalization, as well as those for whom endoscopic or surgical treatment is recommended.

We share our experience with the Oakland scoring system application and compare the results of the application with those of other assessment scales.

The results were analyzed, discussed, and compared with those of European centers.

Author Biographies

  • Anton Svirchev, First University Hospital, Sofia

    Clinic of Endoscopic and General Surgery

  • Krasimir Vasilev, First University Hospital, Sofia

    Clinic of Endoscopic and General Surgery

  • Georgi Gurbev, First University Hospital, Sofia

    Clinic of Endoscopic and General Surgery

References

[1] Tsonev N. Management of gastrointestinal bleeding. ISBN 978-619-7196-83-2. (in Bulgarian).

[2] Kollef MH, O'Brien JD, Zuckerman GR, et al. BLEED: a classification tool to predict outcomes in patients with acute upper and lower gastrointestinal hemorrhage. Crit Care Med. 1997 Jul;25(7):1125-32. doi: 10.1097/00003246-199707000-00011. DOI: https://doi.org/10.1097/00003246-199707000-00011

[3] Aoki T, Yamada A, Nagata N, et al. External validation of the NOBLADS score, a risk scoring system for severe acute lower gastrointestinal bleeding. PLoS One. 2018 Apr 26;13(4):e0196514. doi: 10.1371/journal.pone.0196514. DOI: https://doi.org/10.1371/journal.pone.0196514

[4] Oakland K, Jairath V, Uberoi R, et al. Derivation and validation of a novel risk скор for safe discharge after acute lower gastrointestinal bleeding: a modelling study. Lancet Gastroenterol Hepatol. 2017 Sep;2(9):635-643. doi: 10.1016/S2468-1253(17)30150-4. DOI: https://doi.org/10.1016/S2468-1253(17)30150-4

[5] Oakland K, Kothiwale S, Forehand T, et al. External Validation of the Oakland Скор to Assess Safe Hospital Discharge Among Adult Patients With Acute Lower Gastrointestinal Bleeding in the US. JAMA Netw Open. 2020 Jul 1;3(7):e209630. doi: 10.1001/jamanetworkopen.2020.9630. DOI: https://doi.org/10.1001/jamanetworkopen.2020.9630

[6] Whiteway J, Yim S, Leong N, et al. External Validation of the Oakland Скор for Predicting Safe Discharge in Patients Presenting With Lower Gastrointestinal Bleeding at the William Harvey Hospital in the United Kingdom. Cureus. 2024 Mar 4;16(3):e55497. doi: 10.7759/cureus.55497. DOI: https://doi.org/10.7759/cureus.55497

[7] DiLena DD, Bouvet SC, Somers MJ, et al. Oakland скор to identify low-risk patients with lower gastrointestinal bleeding performs well among emergency department patients. Int J Emerg Med. 2025 Feb 3;18(1):19. doi: 10.1186/s12245-025-00815-5. DOI: https://doi.org/10.1186/s12245-025-00815-5

[8] Almaghrabi M, Gandhi M, Guizzetti L, et al. Comparison of Risk Скорs for Lower Gastrointestinal Bleeding: A Systematic Review and Meta-analysis. JAMA Netw Open. 2022;5(5):e2214253. doi:10.1001/jamanetworkopen.2022.14253 DOI: https://doi.org/10.1001/jamanetworkopen.2022.14253

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Published

2025-09-18

How to Cite

Lower Digestive Hemorrhagic Syndrome. Scoring Systems. (2025). Scripta Scientifica Medica, 57, 36-40. https://doi.org/10.14748/epn62t66