Initial management for acute lower gastrointestinal bleeding

Table 2 Risk scoring systems for severe acute lower gastrointestinal bleeding which have been validated

Derivation study	Outcomes	Risk factors	ROC-AUC	Validation study
Strate et al[21]	Severe bleeding	Syncope	0.76	Prospective cohort (n = 275)
(n = 252)	(continuous and/or recurrent bleeding)	No abdominal tenderness		ROC-AUC: 0.75
		Aspirin use
		Heart rate ≥ 100/min
		Systolic blood pressure ≤ 115 mmHg
		Bleeding per rectum in the first 4 h
		Charlson comorbidity index > 2
Das et al[22]	Rebleeding	(19 factors)	0.92	Prospective cohort (n = 142)
(n = 120)	Need for intervention	Age	0.93
Artificial neural network based model	In-hospital mortality	Comorbidity (5 factors)	0.95
		History (4 factors)
		Features at presentation (2 factors)
		Features at initial assessment (2 factors)
		Initial laboratory data (5 factors)
Aoki et al[24]	Severe bleeding	(NOBLADS)	0.77	Prospective cohort (n = 161)
(n = 439)	(Continuous and/or recurrent bleeding)	NSAIDs use		ROC-AUC: 0.76
		No diarrhea		Retrospective cohort (n = 511)
		No abdominal tenderness		ROC-AUC: 0.74
		Blood pressure (systolic) ≤ 100 mmHg
		Albumin level < 3.0 g/dL
		Antiplatelet drugs use (non-aspirin)
		Disease score ≥ 21
		Syncope
Oakland et al[27]	Safe discharge	Age	0.84	Prospective cohort (n = 288)
(n = 2336)	(Absence of death, rebleeding, intervention, blood transfusion,	Male sex		ROC-AUC: 0.79
	or 28 d readmission)	Blood on rectal examination
		Heart rate
		Systolic blood pressure
		Hemoglobin level
		Previous LGIB admission
Sengupta et al[28]	30 d mortality	Age	0.81	Retrospective cohort (n = 2060)
(n = 4044)		Dementia		ROC-AUC: 0.72
		Metastatic cancer
		Chronic kidney disease
		Chronic pulmonary disease
		Anticoagulant use
		Hematocrit level
		Albumin level

¹Charlson comorbidity index. LGIB: Lower gastrointestinal bleeding; ROC-AUC: The area under the receiver operating characteristics curve.