Response to the recently published guidelines on lower gastrointestinal bleeding

Correspondence to Stephen Thomas Ward, Department of Colorectal Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UK; drsteveward@yahoo.com In response to the recently published national guideline on lower GI bleeding written by Oakland et al,1 we have audited our practice at the Queen Elizabeth Hospital, Birmingham (QEHB). The shock index is a measure used for prediction of critical bleeding in trauma, with some studies applying this to acute GI haemorrhage.3 4 However, the majority of patients presenting with lower GI bleeding are over the age of 70 nationally2 and this is reflected in our patient group (median age: 71 years). In summary, our local audit assessing the positive predictive value of CT angiography in patients presenting with lower GI bleeding is significantly at odds with the results from national data.