oakland_score_lgib: Oakland Score for Safe Discharge in Lower GI Bleed

In cliot: Clinical Indices and Outcomes Tools

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")

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.

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.

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)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.