Background and aims:

Lower gastrointestinal bleeding (LGIB) has a lower prevalence than upper gastrointestinal bleeding (UGIB), but has higher mortality and length of stay. Unlike UGIB, in LGIB there are multiple severity prediction scales, but they are not suitable for all populations. The aim of this study is to determine the usefulness of the scores of risk stratification in patients with LGIB for predicting severe bleeding in our population.

Material and methods:

Retrospective, observational study included patients over 18 years old with LGIB at a single center between January 2016 to May 2019, patients with a history of colorectal cancer or inflammatory bowel disease are excluded. Demographic, clinical and laboratory data were collected in the emergency department, as well as the calculation of risk stratification scales for each of the patients. Descriptive statistics were used, significant difference p <0.05 was considered. Area under the receiver operating characteristic curve (AUC) analysis was used to compare the scores.

Results:

A total of 181 patients, 21% had severe bleeding, 23.2% transfusion, 2.8% rebleed, 2.2% angiography, 10.5% were admitted to intensive care (ICU) and 6.1% required hospital readmission. No patient required surgery or died in hospital. Among the 10 score evaluated, only SHA2PE had an AUC> 0.80 for predicting severe bleeding, rebleeding, transfusion, angiography and admission to ICU.

Conclusion:

SHA2PE score has adequate prediction for severe bleeding in patients with LGIB.

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