Risk scores outperform clinical judgment for safe discharge in lower gastrointestinal bleeding—better patient selection can enhance outcomes.

• The Oakland score showed the highest accuracy (AUC 0.77) for predicting safe discharge, compared to clinical judgment (AUC 0.76).
• Overall, 76.7% of patients achieved safe discharge within 28 days; however, 41 needed transfusions, 24 required endoscopic intervention, and 5 died.

Consider incorporating the Oakland score into practice to aid discharge decisions and reduce readmissions.

• Specificity for the Oakland score reached 94.8%, outperforming other scores in preventing adverse events.