Oakland

Oakland

Principle

Use the first measurements from this episode, before treatment when available.

Scope

Adult · acute lower gastrointestinal bleeding · initial assessment

Interpretation limits

Oakland 2017 model; operational BSG 2019 table, equalities cross-checked against JAMA 2020. Seven contributions, total 0–35; threshold ≤8, without an alternative threshold at 10. Product convention: continuous intervals, inclusive lower and exclusive upper boundary, exact quantities compared without prior rounding. The original and ESGE tables show discordant inequalities and Hb units; BSG is used. The composite outcome is not an individual probability or 28-day mortality. Outside the proposed scope: paediatrics, pregnancy, upper gastrointestinal bleeding, inpatient-onset bleeding and secondary transfer. Unstable rectal bleeding may have an upper source. Clinical instability, ongoing bleeding or another reason for admission always take precedence; heart rate below systolic BP does not establish stability.

Formula and logic

Oakland = age + sex + previous admission + blood on digital rectal examination + HR + SBP + Hb (points).

Interpretation

Disposition interpretation withheld

Prioritise haemodynamic assessment. Do not use this score to support discharge. HR/SBP >1: haemodynamic caution under BSG 2019. HR/SBP =1: product precaution at the boundary, without attributing a definition of instability to BSG 2019.

0–8

Low-risk threshold met.

9–35

Above the low-risk threshold.

0–8

Outpatient care may be considered only with self-limited bleeding, no adverse features, and reliable follow-up and access to reassessment. The score alone does not determine discharge.

9–35

This result does not identify a low-risk profile. Disposition depends on clinical assessment.

Definition version : 1.0.0

Sources

• British Society of Gastroenterology — Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology

  2019 · Table 1: normative scoring table and haemodynamic context.

• Oakland et al. — Derivation and validation of a novel risk score for safe discharge after acute lower gastrointestinal bleeding: a modelling study

  2017 · Seven-variable model; population and composite outcome.

• Oakland et al. — External Validation of the Oakland Score to Assess Safe Hospital Discharge Among Adult Patients With Acute Lower Gastrointestinal Bleeding in the US

  2020 · Cross-check of equalities and units; six-variable data do not authorise clinical imputation.

• ESGE — Diagnosis and management of acute lower gastrointestinal bleeding: European Society of Gastrointestinal Endoscopy Guideline

  2021 · Clinical conditions and follow-up required to consider outpatient care.