Out-of-hours endoscopy for non-variceal upper gastrointestinal bleeding

• Type: Article in International Scientific Journal
• Date: 2015

Authors

Teixeira de Carvalho Pedroto, IMTD (Author) ICBAS; Azevedo Maia, LAA (Author) Other; Durao Salgueiro, PSD (Author) Other; Moreira Teles de Sampaio, EMCMT (Author) Other; Kuettner de Magalhaes, RSK (Author) Other; de Sousa Barbosa Magalhaes, MJDB (Author) Other; Marcos Pinto, RJ (Author) Other; Dias C (Author) FMUP; Mario Dinis Ribeiro (Author) FMUP

Journal

Title: Scandinavian Journal of Gastroenterology

Vol. 50

Pages: 495-502

ISSN: 0036-5521

Publisher: Taylor & Francis

Indexing

ISI Web of Knowledge - 2 Citations

Scopus - 2 Citations

Other information

Authenticus ID: P-00A-7X8

DOI: 10.3109/00365521.2014.964759

Abstract (EN): Background. Most countries lack a well-coordinated approach to out-of-hours endoscopy. Economic constraints and lack of resources have been identified as important barriers. Objective. To assess the performance evaluation of an out-of-hours emergency endoscopy model of care. Design. During a 3 year period (January 2010 to December 2012), data from consecutive outpatients (n = 332) with non-variceal acute upper gastrointestinal bleeding admitted or transferred to a single referral hospital were prospectively collected. Results. 34% (n = 113) were direct admissions whereas 66% (n = 219) were transferred from other hospitals. Median time to upper endoscopy esophagogastroduodenoscopy (EGD) was 6 h and 7.7 h for direct admissions and transferred, respectively. EGD was performed within 24 h in 90% of the patients. Rebleeding, in-hospital mortality, 30 day mortality and need for surgery were respectively 9.8%, 5.8%, 7.4%, and 6.6% and were not significantly different between the two groups. Age, malignancy, and moderate to high clinical Rockall risk score were independent predictors of in-hospital mortality in both groups. Age remained as an important predictor of main outcomes in transferred patients, while comorbidities differed according to admission status and predictable outcomes. Conclusion. This gastroenterology emergency model improved access and equity to out-of-hours endoscopy in an effective, safe, and timely way, recognized by the rates and the homogeneity observed in the outcomes, between transferred patients and direct admissions.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8