Clinical utility of the Oakland score in rectal bleeding: Implications for admission decisions and cost efficiency
Küçük Resim Yok
Tarih
2026
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Springer
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Background Rectal bleeding is a frequent cause of emergency admissions, yet objective criteria for hospitalization remain limited. The Oakland Score was developed to identify low-risk patients suitable for outpatient management. Methods This retrospective single-center study analyzed 346 patients presenting with rectal bleeding between 2015 and 2025. Patients were categorized as low-risk (Oakland <= 8, n = 142) or high-risk (Oakland >= 8, n = 204). Clinical parameters, transfusion, tranexamic acid (TXA) use, and total hospital costs were compared. Results High-risk patients were older (64.2 +/- 14.2 vs 52.4 +/- 14.1 years, p < 0.001), had lower hemoglobin (10.6 +/- 2.2 vs 12.6 +/- 1.9 g/dL, p < 0.001), lower systolic pressure (116.1 +/- 17.0 vs 124.3 +/- 15.2 mmHg, p < 0.001), and higher heart rate (92.5 +/- 14.1 vs 83.2 +/- 11.6 bpm, p < 0.001). Hospital admission (91.2% vs 40.8%), transfusion (35.3% vs 5.6%), and TXA use (73.5% vs 28.2%) were significantly greater in high-risk patients (all p < 0.001). The Oakland Score correlated positively with total cost (r = 0.55, p < 0.001) and length of stay (r = 0.52, p < 0.001). ROC analysis showed excellent discrimination for hospital admission (AUC = 0.86, p < 0.001). Conclusion The Oakland Score reliably predicts both clinical severity and healthcare burden in patients presenting with rectal bleeding. Integrating this simple and objective tool into emergency department protocols can help physicians identify low-risk patients who may be safely discharged, thereby reducing unnecessary hospitalizations, optimizing resource use, and improving overall cost-effectiveness of care.
Açıklama
Anahtar Kelimeler
[Keyword Not Available]
Kaynak
International Journal of Colorectal Disease
WoS Q Değeri
Q2
Scopus Q Değeri
Q2
Cilt
41
Sayı
1
