Journal article
Time to endoscopy for acute upper gastrointestinal bleeding: Results from a prospective multicentre trainee-led audit
United European Gastroenterology journal, Vol.7(2), pp.199-209
10/28/2018
DOI: 10.1177/2050640618811491
PMCID: PMC6498807
PMID: 31080604
Abstract
BackgroundEndoscopy within 24 h of admission (early endoscopy) is a quality standard in acute upper gastrointestinal bleeding (AUGIB). We aimed to audit time to endoscopy outcomes and identify factors affecting delayed endoscopy (>24 h of admission).MethodsThis prospective multicentre audit enrolled patients admitted with AUGIB who underwent inpatient endoscopy between November and December 2017. Analyses were performed to identify factors associated with delayed endoscopy, and to compare patient outcomes, including length of stay and mortality rates, between early and delayed endoscopy groups.ResultsAcross 348 patients from 20 centres, the median time to endoscopy was 21.2 h (IQR 12.0–35.7), comprising median admission to referral and referral to endoscopy times of 8.1 h (IQR 3.7–18.1) and 6.7 h (IQR 3.0–23.1), respectively. Early endoscopy was achieved in 58.9%, although this varied by centre (range: 31.0–87.5%, p = 0.002). On multivariable analysis, lower Glasgow–Blatchford score, delayed referral, admissions between 7:00 and 19:00 hours or via the emergency department were independent predictors of delayed endoscopy. Early endoscopy was associated with reduced length of stay (median difference 1 d; p = 0.004), but not 30-d mortality (p = 0.344).ConclusionsThe majority of centres did not meet national standards for time to endoscopy. Strategic initiatives involving acute care services may be necessary to improve this outcome.
Details
- Title: Subtitle
- Time to endoscopy for acute upper gastrointestinal bleeding: Results from a prospective multicentre trainee-led audit
- Creators
- Keith Siau - Royal College of PhysiciansJames HodsonRichard IngramAndrew BaxterMonika M. WidlakCaroline SharrattGraham M. BakerTom TrothBen HickenFaraz TahirMalik MagrabiNouman YousafClaire GrantDennis PoonHesham KhalilHui Lin LeeJonathan R. WhiteHuey TanSyazeddy SamaniPatricia HooperSaeed AhmedMuhammad AminSara MahgoubKhayal AsgharFarique LeetMatthew J HarborneBeata PolewiczowskaSheeba KhanMuhammad R. AnjumMichael McFarlaneElla MozdiakLauren D. O’FlynnIlona C. BleeRachel M. MolyneuxAshok KurianSyed N AbbasAbdullah AbbasiAadil KarimAsif YasinFawad KhattakJosephine WhiteRuhina AhmedJames A. MorganLance AlleyneMohamed A. AlamNaaventhan PalaniyappanVictoria J. RodgerParamvir SawhneyNasar AslamTheodore OkekeAdam LawsonDanny CheungJeremy P. ReidAshish AwasthiMark R. AndersonJoe R. TimothySanjeev PattniSaqib AhmadGillian TownsonJeremy ShearmanVanja GiljacaMatthew J. BrookesBen R DisneyNeil GuhaTitus ThomasAnthony NormanPeter WurmAshit ShahNeil C. FisherSauid IshaqGiles Major
- Resource Type
- Journal article
- Publication Details
- United European Gastroenterology journal, Vol.7(2), pp.199-209
- DOI
- 10.1177/2050640618811491
- PMID
- 31080604
- PMCID
- PMC6498807
- NLM abbreviation
- United European Gastroenterol J
- ISSN
- 2050-6406
- eISSN
- 2050-6414
- Publisher
- SAGE Publications
- Grant note
- charity Guts UKNational Institute for Health Research: ACF-2016-12-001
WMRIG and GARNet have been awarded a research network grant by the charity Guts UK.
- Language
- English
- Date published
- 10/28/2018
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984843581302771
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