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Background: Angioembolization is a useful therapeutic tool for lower gastrointestinal bleeding (LGIB) however is only available at centres with specialist interventional radiology departments. Delay in angioembolization of greater than 120–150 minutes is associated with higher rates of non‐therapeutic angioembolization. Methods: This retrospective review analysed the impact of interhospital transfer on timing and success of angioembolization in adults with LGIB. Results: Of the 121 patients who underwent CTMA at a peripheral hospital for LGIB, only 20.7% had positive CTMA (n = 25). Of the 24 patients who were transferred for the purpose of angioembolization, only five ultimately had successful embolisation (20.1%). Patients who had unsuccessful angioembolization had a significantly longer mean time from arrival at the tertiary hospital to angioembolization compared to patients who had successful angioembolization (mean 375 versus 175 min, P = 0.001). There was no association of patient haemodynamics, use of anticoagulant or antiplatelet therapy, and transfusion requirement with success of angioembolization. Conclusion: Interhospital transfer is associated with delay in angioembolization. Delay after arrival at the receiving hospital is associated with unsuccessful angioembolization. [ABSTRACT FROM AUTHOR]

Background: Bleeding of the gastrointestinal tract (BGIT) is a common gastrointestinal emergency. There is no consensus whether this condition should be admitted to medical or surgical discipline. Timing of presentation may also impact patient outcomes due to differences in healthcare resource availability. This study thus aims to investigate the impact of admitting discipline and timing of admission on patient outcomes in BGIT. Methods: A 2‐year tertiary institution database was retrospectively reviewed. Outcome measures included 30‐day mortality, 30‐day readmissions and rebleeding requiring repeat endoscopic, angiographic or surgical interventions. Secondary outcome measures included time to endoscopy, percutaneous angiographic interventions and surgery. The effect of admission discipline (medical versus surgical) and time of admission (office‐hours versus after office‐hours) were analysed using a propensity‐score‐adjusted estimate. Results: A total of 1384 patients were included for analysis, medical (n = 853), surgical (n = 530); during office‐hours (n = 785) and after office‐hours (n = 595). After propensity‐score‐adjusted analysis, no significant differences in mortality or readmissions were noted between medical or surgical admissions. Patients admitted under surgery were less likely to sustain rebleeding (P = 0.004) for lower BGIT and had an earlier time to endoscopy for upper BGIT (P = 0.04). Patients admitted after office‐hours had similar outcomes with those admitted during office hours apart from a delay in time to endoscopy (P = 0.02). Conclusion: For BGIT patients, admission to a surgical discipline compared to a medical discipline appeared to have at least equivalent patient outcomes. Patients presenting with BGIT after office‐hours were more likely to experience a delay to endoscopy, although it did not affect patient mortality. [ABSTRACT FROM AUTHOR]