Abstract：
BACKGROUND: Acute lower gastrointestinal bleeding (ALGIB) is a common cause of hospitalization. Recent guidelines recommend the use of prognostic scales for risk stratification. However, it remains unclear whether risk scores are more accurate than some simpler prognostic variables.
OBJECTIVE: To compare the predictive values of haemoglobin alone and the Oakland score for predicting outcomes in ALGIB patients.
METHODS: Single-centre, retrospective study at a University Hospital. Data were extracted from the hospital\'s clinical records. The Oakland score was calculated at admission. Study outcomes were defined according to the original article describing the Oakland score: safe discharge (the primary Oakland score outcome), transfusion, rebleeding, readmission, therapeutic intervention and death. Area under the receiver operating characteristics (AUROC) curve and accuracy using haemoglobin and the Oakland score were calculated for each outcome.
RESULTS: Two hundred and fifty-eight patients were included. Eighty-four (32.6%) needed transfusion, 50 (19.4%) presented rebleeding, 31 (12.1%) required therapeutic intervention, 20 (7.8%) were readmitted and six (2.3%) died. There were no differences in the AUROC curve values for haemoglobin versus the Oakland score with regard to safe discharge (0.82 (0.77-0.88) vs 0.80 (0.74-0.86), respectively) or to therapeutic intervention and death. Haemoglobin was significantly better for predicting transfusion and rebleeding, and the Oakland score was significantly better for predicting readmission.
CONCLUSIONS: In our study, the Oakland score did not perform better than haemoglobin alone for predicting the outcome of patients with ALGIB. The usefulness of risk scores for predicting outcomes in clinical practice remains uncertain.
OBJECTIVE: To compare the predictive values of haemoglobin alone and the Oakland score for predicting outcomes in ALGIB patients.
METHODS: Single-centre, retrospective study at a University Hospital. Data were extracted from the hospital\'s clinical records. The Oakland score was calculated at admission. Study outcomes were defined according to the original article describing the Oakland score: safe discharge (the primary Oakland score outcome), transfusion, rebleeding, readmission, therapeutic intervention and death. Area under the receiver operating characteristics (AUROC) curve and accuracy using haemoglobin and the Oakland score were calculated for each outcome.
RESULTS: Two hundred and fifty-eight patients were included. Eighty-four (32.6%) needed transfusion, 50 (19.4%) presented rebleeding, 31 (12.1%) required therapeutic intervention, 20 (7.8%) were readmitted and six (2.3%) died. There were no differences in the AUROC curve values for haemoglobin versus the Oakland score with regard to safe discharge (0.82 (0.77-0.88) vs 0.80 (0.74-0.86), respectively) or to therapeutic intervention and death. Haemoglobin was significantly better for predicting transfusion and rebleeding, and the Oakland score was significantly better for predicting readmission.
CONCLUSIONS: In our study, the Oakland score did not perform better than haemoglobin alone for predicting the outcome of patients with ALGIB. The usefulness of risk scores for predicting outcomes in clinical practice remains uncertain.
摘要：
背景：急性下消化道出血（ALGIB）是住院的常见原因。最近的指南推荐使用预后量表进行风险分层。然而,目前尚不清楚风险评分是否比一些更简单的预后变量更准确.
目的：比较单独血红蛋白和奥克兰评分对ALGIB患者预后的预测价值。
方法：单中心，在大学医院进行的回顾性研究。数据从医院的临床记录中提取。奥克兰分数是在入院时计算的。根据描述奥克兰评分的原始文章定义研究结果：安全出院（奥克兰主要评分结果），输血,再出血,重新接纳,治疗干预和死亡。对于每个结果,计算受试者工作特征(AUROC)曲线下面积和使用血红蛋白的准确度和奥克兰评分。
结果：纳入了二百五十八个患者。八十四人(32.6%)需要输血，50（19.4%）出现再出血，31（12.1%）需要治疗干预，20例（7.8%）再次入院，6例（2.3%）死亡。就安全出院而言，血红蛋白与奥克兰评分的AUROC曲线值无差异（0.82（0.77-0.88）vs0.80（0.74-0.86），分别)或治疗性干预和死亡。血红蛋白对预测输血和再出血明显更好，奥克兰评分在预测再入院方面明显更好。
结论：在我们的研究中，在预测ALGIB患者的结局方面,奥克兰评分并不优于单独的血红蛋白.风险评分在临床实践中预测结果的有用性仍不确定。
目的：比较单独血红蛋白和奥克兰评分对ALGIB患者预后的预测价值。
方法：单中心，在大学医院进行的回顾性研究。数据从医院的临床记录中提取。奥克兰分数是在入院时计算的。根据描述奥克兰评分的原始文章定义研究结果：安全出院（奥克兰主要评分结果），输血,再出血,重新接纳,治疗干预和死亡。对于每个结果,计算受试者工作特征(AUROC)曲线下面积和使用血红蛋白的准确度和奥克兰评分。
结果：纳入了二百五十八个患者。八十四人(32.6%)需要输血，50（19.4%）出现再出血，31（12.1%）需要治疗干预，20例（7.8%）再次入院，6例（2.3%）死亡。就安全出院而言，血红蛋白与奥克兰评分的AUROC曲线值无差异（0.82（0.77-0.88）vs0.80（0.74-0.86），分别)或治疗性干预和死亡。血红蛋白对预测输血和再出血明显更好，奥克兰评分在预测再入院方面明显更好。
结论：在我们的研究中，在预测ALGIB患者的结局方面,奥克兰评分并不优于单独的血红蛋白.风险评分在临床实践中预测结果的有用性仍不确定。
