{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T20:53:02Z","timestamp":1783630382362,"version":"3.55.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background\/Objectives<\/jats:title>\n                <jats:p>The Oakland score was developed to predict safe discharge in patients who present to the emergency department with lower gastrointestinal bleeding (LGIB). In this study, we retrospectively evaluated if this score can be implemented to assess safe discharge (score\u2009\u2264\u200910) at WellStar Atlanta Medical Center (WAMC).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective cohort study of 108 patients admitted at WAMC from January 1, 2020 to December 30, 2021 was performed. Patients with LGIB based on the ICD-10 codes were included. Oakland score was calculated using 7 variables (age, sex, previous LGIB, digital rectal exam, pulse, systolic blood pressure (SBP) and hemoglobin (Hgb)) for all patients at admission and discharge from the hospital. The total score ranges from 0 to 35 and a score of \u2264\u200910 is a cut-off that has been shown to predict safe discharge. Hgb and SBP are the main contributors to the score, where lower values correspond to a higher Oakland score. Descriptive and multivariate analysis was performed using SPSS 23 software.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 108 patients met the inclusion criteria, 53 (49.1%) were female with racial distribution was as follows: 89 (82.4%) African Americans, 17 (15.7%) Caucasian, and 2 (1.9%) others. Colonoscopy was performed in 69.4% patients; and 61.1% patients required blood transfusion during hospitalization. Mean SBP records at admission and discharge were 129.0 (95% CI, 124.0-134.1) and 130.7 (95% CI,125.7-135.8), respectively. The majority (59.2%) of patients had baseline anemia and the mean Hgb values were 11.0 (95% CI, 10.5\u201311.5) g\/dL at baseline prior to hospitalization, 8.8 (95% CI, 8.2\u20139.5) g\/dL on arrival and 9.4 (95% CI, 9.0-9.7) g\/dL at discharge from hospital. On admission, 100\/108 (92.6%) of patients had an Oakland score of &gt;\u200910 of which almost all patients (104\/108 (96.2%)) continued to have persistent elevation of Oakland Score greater than 10 at discharge. Even though, the mean Oakland score improved from 21.7 (95% CI, 20.4\u201323.1) of the day of arrival to 20.3 (95% CI, 19.4\u201321.2) at discharge, only 4\/108 (3.7%) of patients had an Oakland score of \u2264\u200910 at discharge. Despite this, only 9\/108 (8.33%) required readmission for LGIB during a 1-year follow-up. We found that history of admission for previous LGIB was associated with readmission with adjusted odds ratio 4.42 (95% CI, 1.010-19.348, <jats:italic>p<\/jats:italic>\u2009=\u20090.048).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In this study, nearly all patients who had Oakland score of &gt;\u200910 at admission continued to have a score above 10 at discharge. If the Oakland Score was used as the sole criteria for discharge most patients would not have met discharge criteria. Interestingly, most of these patients did not require readmission despite an elevated Oakland score at time of discharge, indicating the Oakland score did not really predict safe discharge. A potential confounder was the Oakland score did not consider baseline anemia during calculation. A prospective study to evaluate a modified Oakland score that considers baseline anemia could add value in this patient population.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12876-024-03283-y","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T09:02:37Z","timestamp":1721034157000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Single center assessment of the role of Oakland score among patients admitted for acute lower gastrointestinal bleeding"],"prefix":"10.1186","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6504-9348","authenticated-orcid":false,"given":"Luis M.","family":"Nieto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihienew","family":"Bezabih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon I.","family":"Narvaez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaturia","family":"Rouse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charleigh","family":"Perry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth J.","family":"Vega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jami","family":"Kinnucan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"issue":"2","key":"3283_CR1","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1053\/j.gastro.2021.10.017","volume":"162","author":"AF Peery","year":"2022","unstructured":"Peery AF, et al. Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: Update 2021. Gastroenterology. 2022;162(2):621\u201344.","journal-title":"Gastroenterology"},{"issue":"9","key":"3283_CR2","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1016\/S2468-1253(17)30150-4","volume":"2","author":"K Oakland","year":"2017","unstructured":"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\u201343.","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"4","key":"3283_CR3","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1038\/ajg.2016.41","volume":"111","author":"LL Strate","year":"2016","unstructured":"Strate LL, Gralnek IM. ACG Clinical Guideline: management of patients with acute lower gastrointestinal bleeding. Am J gastroenterol. 2016;111(4):459\u201374.","journal-title":"Am J Gastroenterol"},{"key":"3283_CR4","doi-asserted-by":"crossref","unstructured":"Ca\u00f1amares P, Alfaro E, Lanas A. Safe hospital discharge based on lower GI bleeding scores: a long way to go. AME Med J, 2017;2(9).","DOI":"10.21037\/amj.2017.09.08"},{"issue":"7","key":"3283_CR5","doi-asserted-by":"publisher","first-page":"e209630","DOI":"10.1001\/jamanetworkopen.2020.9630","volume":"3","author":"K Oakland","year":"2020","unstructured":"Oakland K, et al. External validation of the Oakland Score to assess safe hospital discharge among adult patients with acute lower gastrointestinal bleeding in the US. JAMA Netw Open. 2020;3(7):e209630.","journal-title":"JAMA Netw Open"},{"issue":"1","key":"3283_CR6","doi-asserted-by":"publisher","first-page":"1914","DOI":"10.1080\/07853890.2021.1990391","volume":"53","author":"X Ai","year":"2021","unstructured":"Ai X, et al. Prediction of severity and outcomes of colon ischaemia using a novel prognostic model: a clinical multicenter study. Ann Med. 2021;53(1):1914\u201323.","journal-title":"Ann Med"},{"issue":"5","key":"3283_CR7","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1016\/j.gie.2018.12.011","volume":"89","author":"N Tapaskar","year":"2019","unstructured":"Tapaskar N, et al. Comparison of clinical prediction tools and identification of risk factors for adverse outcomes in acute lower GI bleeding. Gastrointest Endosc. 2019;89(5):1005\u2013e10132.","journal-title":"Gastrointest Endosc"},{"issue":"1","key":"3283_CR8","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1159\/000521288","volume":"91","author":"ME Charlson","year":"2022","unstructured":"Charlson ME, Carrozzino D, Guidi J, Patierno C. Charlson comorbidity index: a critical review of clinimetric properties. Psychother psychosom. 2022;91(1):8\u201335. https:\/\/doi.org\/10.1159\/000521288.","journal-title":"Psychother Psychosom"},{"issue":"5","key":"3283_CR9","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1136\/gutjnl-2018-317807","volume":"68","author":"K Oakland","year":"2019","unstructured":"Oakland K, et al. Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the british society of gastroenterology. Gut. 2019;68(5):776\u201389.","journal-title":"Gut"},{"issue":"2","key":"3283_CR10","doi-asserted-by":"publisher","first-page":"208","DOI":"10.14309\/ajg.0000000000002130","volume":"118","author":"N Sengupta","year":"2023","unstructured":"Sengupta N, et al. Management of patients with acute lower gastrointestinal bleeding: an updated ACG guideline. Official J Am coll gastroenterol | ACG. 2023;118(2):208\u201331.","journal-title":"Official J Am Coll Gastroenterol | ACG"},{"issue":"1","key":"3283_CR11","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/s13017-021-00402-y","volume":"16","author":"M Singh","year":"2021","unstructured":"Singh M, et al. A clinical predictive model for risk stratification of patients with severe acute lower gastrointestinal bleeding. World J emerg surg. 2021;16(1):58.","journal-title":"World J Emerg Surg"},{"issue":"4","key":"3283_CR12","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1055\/s-0032-1329393","volume":"25","author":"T Raphaeli","year":"2012","unstructured":"Raphaeli T, Menon R. Current treatment of lower gastrointestinal hemorrhage. Clin colon rectal surg. 2012;25(4):219\u201327.","journal-title":"Clin Colon Rectal Surg"},{"issue":"8","key":"3283_CR13","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1016\/j.mayocp.2015.04.024","volume":"90","author":"N Sengupta","year":"2015","unstructured":"Sengupta N, et al. Risk factors for adverse outcomes in patients hospitalized with lower gastrointestinal bleeding. Mayo clin proc. 2015;90(8):1021\u20139.","journal-title":"Mayo Clin Proc"},{"issue":"8","key":"3283_CR14","doi-asserted-by":"publisher","first-page":"3948","DOI":"10.1007\/s10620-021-07243-4","volume":"67","author":"S Sharma","year":"2022","unstructured":"Sharma S, et al. Early Colonoscopy does not affect 30-Day readmission after lower GI bleeding: insights from a nationwide analysis. Dig Dis Sci. 2022;67(8):3948\u201354.","journal-title":"Dig Dis Sci"},{"issue":"8","key":"3283_CR15","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1097\/MCG.0000000000001020","volume":"53","author":"S Patel","year":"2019","unstructured":"Patel S, Desai R, Patel U, et al. Thirty-day readmissions after upper and lower gastrointestinal hemorrhage. J clin gastroenterol. 2019;53(8):582\u201390. https:\/\/doi.org\/10.1097\/MCG.0000000000001020.","journal-title":"J Clin Gastroenterol"},{"issue":"5","key":"3283_CR16","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1002\/jhm.1901","volume":"7","author":"M Reid","year":"2012","unstructured":"Reid M, Keniston A, Heller JC, Miller M, Medvedev S, Albert RK. Inappropriate prescribing of proton pump inhibitors in hospitalized patients. J Hosp Med. 2012;7(5):421\u20135. https:\/\/doi.org\/10.1002\/jhm.1901.","journal-title":"J Hosp Med"},{"issue":"6","key":"3283_CR17","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1097\/MAJ.0b013e31829f87d5","volume":"347","author":"AM Ladd","year":"2014","unstructured":"Ladd AM, Panagopoulos G, Cohen J, Mar N, Graham R. Potential costs of inappropriate use of proton pump inhibitors. Am J Med Sci. 2014;347(6):446\u201351. https:\/\/doi.org\/10.1097\/MAJ.0b013e31829f87d5.","journal-title":"Am J Med Sci"},{"key":"3283_CR18","doi-asserted-by":"publisher","unstructured":"Andrew J, Quinn H, Saven R, Haile et al. Inappropriate use of proton pump inhibitors In hospitalized patients with lower Gastrointestinal bleeding. https:\/\/doi.org\/10.1016\/j.gie.2022.04.502.","DOI":"10.1016\/j.gie.2022.04.502"},{"issue":"6","key":"3283_CR19","doi-asserted-by":"publisher","first-page":"e00588","DOI":"10.14309\/ctg.0000000000000588","volume":"14","author":"X Zhang","year":"2023","unstructured":"Zhang X, Xiao X, Chen PR, Li YN, Lv XH, Yang JL. Proton Pump inhibitors increase the risk of nonsteroidal anti-inflammatory drug-related small-bowel Injury: a systematic review with Meta-analysis. Clin Transl Gastroenterol. 2023;14(6):e00588. https:\/\/doi.org\/10.14309\/ctg.0000000000000588. Published 2023 Jun 1.","journal-title":"Clin Transl Gastroenterol"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-024-03283-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-024-03283-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-024-03283-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T09:07:22Z","timestamp":1721034442000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-024-03283-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,15]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3283"],"URL":"https:\/\/doi.org\/10.1186\/s12876-024-03283-y","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,15]]},"assertion":[{"value":"8 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was reviewed and approved by the Institutional Review Board (IRB) of the WellStar Research and Ethics committee lead by Joy Peterson, PharmD, IRB Chairman of WellStar Research Institute, and approved exempt from requiring informed consent by the IRB of WellStar Research Institute, Research and Ethics committee (Marietta, GA).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"225"}}