Validation of a Clinical Prediction Rule for Severe Acute Lower Intestinal Bleeding

Abstract

We have developed and prospectively validated a clinical prediction rule for acute severe lower intestinal bleeding. This prediction rule could improve the triage of patients to appropriate levels of care and interventions, and guide a more standardized approach to acute lower intestinal bleeding.

Development and Validation of a Risk Scoring System for Severe Acute Lower Gastrointestinal Bleeding

“…Saltzman et al 18 developed AIMS65 scores for UGIB that were associated with LOS and cost. In LGIB, Strate et al 5 reported that rates of surgery, death, LOS, and transfusion were significantly higher in patients with more risk factors for severe LGIB.…”

Interventional management of lower gastrointestinal bleeding

“…Based on data available to the clinician at patient presentation, a model is proposed to predict outcomes for patients with LGIB [29]. Seven risk factors are identified in this model: heart rate >100, systolic blood pressure <115, syncope, nontender abdominal examination, rectal bleeding within the first 4 h of evaluation, aspirin use in the week prior to evaluation, and >2 comorbid illnesses.…”

Acute Lower Gi Bleeding for the Acute Care Surgeon: Current Diagnosis and Management

“…Strate et al retrospectively reviewed patients admitted for lGIB and identified seven predictors of severe bleeding: heart rate ≥ 100, systolic blood pressure ≤ 115mmHg, syncope, non-tender abdominal exam, gross rectal bleeding, aspirin use, and >2 comorbidities (Table 1) (17). patients with >3 risk factors had an 84% risk of severe bleeding defined as transfusion of >2units of red blood cells (18). Classification systems, however,d on ot predict need or possibility for surgical or angiographic intervention.…”