《Table 3 Utility of early colonoscopy compared with elective colonoscopy according to randomized con

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《Initial management for acute lower gastrointestinal bleeding》

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1Primary end point was rebleeding；2Primary end point was further bleeding（continuous bleeding and/or rebleeding）；3Meta-analyses included 2 randomized controlled trials；4Odds ratio（95%confidential interval）.RCT:Randomized controlled trial；NS:Not signifi

Physicians must understand the predictive factors for severe LGIB to improve triage of appropriate patients for emergency hospitalization or early intervention.Several studies have investigated risk factors for adverse outcomes（rebleeding，severe bleeding，need for emergent hospitalization，need for intervention，adverse events，or death）in patients with acute LGIB[7，8，20-28].These include older age，presenting symptoms（no abdominal tenderness，no diarrhea，altered mental status，or blood on rectal examination），vital signs，comorbidities，medication use[nonsteroidal antiinflammatory drugs（NSAIDs）and antithrombotic agents]，and laboratory data[hemoglobin（Hb），hematocrit，albumin，BUN，Cr，and prothrombin time（PT）]（Table1）.We also previously reported a predictive model of severe LGIB（NOBLADS score），which included NSAID use，no diarrhea，no abdominal tenderness，systolic blood pressure≤100 mmHg，albumin level<3.0 g/dL non-aspirin antiplatelet drug use，Charlson comorbidity index score≥2，and syncope[24].Several predictive models have been validated in other settings（Table 2）[21，22，24，27，28].Applying these models to manage LGIB could improve clinical outcomes and resource utilization.However，compared with established models of severe UGIB[29，30]such as the Blatchford score，predictive models of severe LGIB require further validation and improvements in accuracy.