cliot (version 1.0.0)

oakland_score_lgib: Oakland Score for Safe Discharge in Lower GI Bleed

Description

Calculates the Oakland Score to identify patients with lower gastrointestinal bleeding (LGIB) who are at low risk of adverse outcomes and can be safely discharged from the emergency department. A score of 8 or less indicates a 95% probability of safe discharge (defined as absence of rebleeding, transfusion, therapeutic intervention, in-hospital death, or readmission).

Usage

oakland_score_lgib(age, sex, previous_lgib_admission, dre_blood, heart_rate,
                   systolic_bp, hemoglobin, hemoglobin_units = "g/dL")

Value

A list containing:

Oakland_Score

The calculated total score (Range 0-35+).

Recommendation

Guidance on discharge vs. admission based on the cutoff of 8.

Probability_Safe_Discharge

Estimated probability of safe outcome.

Arguments

age

Numeric. Patient age in years. <40: 0 pts. 40-69: 0 pts. 70-79: 1 pt. >=80: 2 pts.

sex

String. Patient sex ("Male" or "Female"). Male adds 1 point.

previous_lgib_admission

Numeric (0 or 1). History of previous admission for lower GI bleed. (1 = Yes, +1 pt).

dre_blood

Numeric (0 or 1). Blood present on digital rectal examination. (1 = Yes, +1 pt).

heart_rate

Numeric. Heart rate in beats per minute. <70: 0 pts. 70-89: 1 pt. 90-109: 2 pts. >=110: 3 pts.

systolic_bp

Numeric. Systolic blood pressure in mmHg. <90: 5 pts. 90-119: 4 pts. 120-129: 3 pts. 130-159: 2 pts. >=160: 0 pts.

hemoglobin

Numeric. Hemoglobin level.

hemoglobin_units

String. Units for hemoglobin input. Options: "g/dL" (default), "g/L", or "mmol/L". Scoring (g/L equivalent): <70: 22 pts. 70-89: 17 pts. 90-109: 13 pts. 110-129: 8 pts. 130-159: 4 pts. >=160: 0 pts.

References

Oakland K, Jairath V, Uberoi R, et al. Derivation and validation of a novel risk score for safe discharge after acute lower gastrointestinal bleeding. Gut. 2017;66(4):635-643. doi:10.1136/gutjnl-2015-311005

Examples

# Example 1: Low Risk (Safe Discharge)
# 45yo Female (0), No prev admit (0), No DRE blood (0), HR 65 (0), SBP 140 (2), Hb 14 (4)
# Score = 0 + 0 + 0 + 0 + 0 + 2 + 4 = 6
oakland_score_lgib(45, "female", 0, 0, 65, 140, 14.0)

# Example 2: High Risk (Admission)
# 75yo Male (1+1), Prev Admit (1), DRE Blood (1), HR 100 (2), SBP 100 (4), Hb 10 (13)
# Score = 1 + 1 + 1 + 1 + 2 + 4 + 13 = 23
oakland_score_lgib(75, "male", 1, 1, 100, 100, 10.0)