Quality of Upper Gastrointestinal Bleeding Risk Stratification and Pre-Endoscopic Management at an Irish University Teaching Hospital

Aims To audit of admission risk stratification and quality of pre-endoscopic management using the 2015 European Society of Gastrointestinal Endoscopy (ESGE) Upper GI Non-Variceal Bleeding guideline as a standard.

Methods Retrospective study analysing electronic endoscopy database from an academic teaching hospital over a 10-month period. All OGDs performed due to the indication of haematemesis, melaena and anaemia analysed. Patients were excluded if procedure was performed as an outpatient. Clinical data was obtained from Electronic Patient Records.

Results 107 upper GI endoscopies were identified. Glasgow Blatchford score (GBS) was documented on patient notes in 24 patients (22 %). Retrospective calculation of GBS revealed 9 patients had a GBS of 0 or 1 (8 %) with a cumulative inpatient stay of 64 days. No endoscopic intervention was performed in patients with a GBS of 0 or 1. 10 patients (9.3 %) received blood transfusion prior to endoscopy despite a haemoglobin >9g/dL. The median time to endoscopy was 37 hours. 85.7 % of patients with high risk GBS (≥12) received early endoscopy ( < 24hours)

Conclusions GBS is a clinically useful and validated risk assessment score in correctly identifying very low-risk patients suitable for outpatient management and subsequent saving in hospital bed days. It is underutilised at point of admission/referral. Consideration of restrictive transfusion strategy should be given as it is associated with improved early survival rates.

Citation: Elsiddig M, McKenna-Barry M, Varley R et al. eP55 QUALITY OF UPPER GASTROINTESTINAL BLEEDING RISK STRATIFICATION AND PRE-ENDOSCOPIC MANAGEMENT AT AN IRISH UNIVERSITY TEACHING HOSPITAL. Endoscopy 2021; 53: S114.

Publication History

Article published online:
19 March 2021