1. Evaluation of the need for endoscopy to identify low-risk patients presenting with an acute upper gastrointestinal bleed suitable for early discharge
- Author
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G G, Robins, M S, Sarwar, M J, Armstrong, M, Armstrong, M E, Denyer, S, Bush, T, Hassan, and S M, Everett
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Risk Assessment ,Risk Factors ,medicine ,Upper gastrointestinal ,Humans ,Endoscopy, Digestive System ,Early discharge ,Aged ,medicine.diagnostic_test ,business.industry ,General surgery ,Patient Selection ,General Medicine ,Length of Stay ,Middle Aged ,Patient Discharge ,Endoscopy ,Surgery ,Upper gastrointestinal bleed ,Acute upper GI bleeding ,Multicenter study ,Acute Disease ,Female ,Original Article ,business ,Risk assessment ,Gastrointestinal Hemorrhage ,Relevant information - Abstract
Aims To audit the safety of differing protocol-driven early-discharge policies, from two sites, for low-risk acute upper gastrointestinal (GI) bleeding and determine if default early ( Methods All patients with low-risk acute upper GI bleeding presenting to two separate hospital sites in Leeds from August 2002 to March 2005 were identified. Both hospitals operate nurse-led process-driven protocols for discharge within 24 h, but only one includes default endoscopy. Relevant information was obtained from patients' notes, patient administration systems, discharge letters and endoscopy records. Results 120 patients were admitted to site A and 74 to site B. Median length of stay on the clinical decisions unit was 12.6 h at site A and 9.4 h at site B (p = 0.045). Oesophagogastroduodenoscopy was performed on 89/120 (74%) patients at site A compared with only 7/74 (9%) at site B (p Conclusions Patients admitted with a low-risk acute upper GI bleeding can be managed safely by a nurse-led process-driven protocol, based on readily available clinical and laboratory variables, with early discharge
- Published
- 2007