Oakland Score for Lower GI Bleeding
Predicts safe discharge of adult patients presenting with acute lower GI bleeding. Score ≤8 associated with >95% probability of safe discharge.
Score interpretation
95 % probability of safe discharge (no rebleeding, transfusion, therapeutic intervention, 28-day readmission or death).
→ If there is no other reason for admission, discharge with urgent outpatient investigation (BSG 2019); give return advice.
Not low risk: admission for further management is appropriate.
→ Admit; colonoscopy on the next available list. If haemodynamically unstable after resuscitation (shock index > 1), CT angiography then embolisation or endoscopy (BSG 2019).
Interpretation bands for the Oakland Score. Apply clinical judgement and local guidance.
References
- Oakland K, et al. Derivation and validation of a novel risk score for safe discharge after acute lower gastrointestinal bleeding: a modelling study. Lancet Gastroenterol Hepatol. 2017;2(9):635–643.
- Oakland K, et al. Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology. Gut. 2019;68(5):776–789.
Related
Curated clinical cross-links plus same-class fallbacks.
- Vasopressin / Terlipressin · Vasopressin Analogue — Vasodilatory Shock / Variceal Bleeding
- Hydrocortisone Acetate Rectal Foam / Enema · Topical Rectal Corticosteroid
- Sodium Acid Phosphate Enema · Osmotic / Stimulant Rectal Laxative
- Glycerol Suppositories · Stimulant / Osmotic Rectal Laxative
- Budesonide (Oral / Rectal) · Corticosteroid — Locally Acting (GI)
- Diazepam (Rectal) · Benzodiazepine / Antiepileptic
- Acute Liver Failure · EASL 2017 / BSG
- Decompensated Cirrhosis · BSG 2015 / EASL 2018
- IBD Acute Flare Assessment · ECCO / BSG 2019
- Hepatitis B Management · EASL 2017 / NICE NG33
- Dysphagia Assessment Pathway · BSG 2010 / NICE NG12
- Paracetamol overdose · TOXBASE/NPIS; MHRA DSU 2012/2024; SNAP regimen (Lancet 2014)
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.