Early Predictors of Severity in Acute Lower Intestinal Tract Bleeding

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Abstract
ACUTE LOWER intestinal tract bleeding (LIB) is a common and potentially life-threatening disorder with an estimated annual incidence of hospitalization of 20 to 30 per 100 000 persons.1 Bleeding occurs primarily in elderly patients and can result in substantial morbidity and mortality.1,2 A significant proportion of patients with acute LIB experience severe, persistent hemorrhage.3,4 Accurate triage is essential to ensure that these patients receive aggressive supportive care and urgent interventions. Recent data suggesting that early colonoscopic intervention (within 12 hours of hospital admission) can improve outcomes in select populations with LIB5-7 highlight the importance of targeting severely bleeding patients. However, identification of high-risk patients with LIB is challenging. The differential diagnosis of LIB is broad,8,9 and current diagnostic modalities are time and resource intensive. Moreover, LIB is frequently intermittent,10,11 often obscuring the source and severity of bleeding.