Safe Discharge in Lower Gastrointestinal Bleeding

Germans Trias i Pujol Hospital398 enrolled

Overview

The increasing incidence in lower gastrointestinal bleeding (LGIB) leads to a rise in hospital admission. Many LGBI are self-limiting thus the several scores to identify low risk patients suited to outpatient care have been described. We aim to compare two of this scores (Oakland score and SHA2PE score) in terms of performace to predict "safe discharge" from the emergency department.

The growing incidence of lower gastrointestinal bleeding (LGIB) is leading to a rise in hospital admissions even though most LGIB episodes are self-limiting. The Oakland and SHA2PE scores were designed to identify patients best suited to outpatient care. Our aim is to validate the SHA2PE score and compare both of these scores in terms of predictiveness of safe discharge. We conducted a retrospective observational study of LGIB patients admitted to our hospital between June 2014-June 2019. During this period, data from all LGIB episodes admitted from the ED were collected in an electronic anonymized database created specifically for this study. If any of the principal variables or critical information was missing, the patient was excluded from the study.

Study Type

OBSERVATIONAL

Enrollment

398

Conditions

Lower GI Bleeding

Interventions

Safe dischargeOTHER

There was no specific intervention, we only aimed to see if those admitted patients could have been safely dicharged from the emergency department.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * All \> 18 year old patients, male and women, admitted to our hospital between June 2014 and June 2019 because of LGIB (lower gastrointestinal bleeding). Exclusion Criteria: * Patients in whom LGIB occurred while already admitted for an other cause. * Patients with LGIB transferred from another hospital due to comorbidities or severity of the gastrointestinal bleeding episode. * Patients with post-polypectomy LGIB (endoscopic polypectomy \<14 days before admission). * Patients with gastrointestinal bleeding of unknown origin after a complete study. * Patients who had undergone digestive tract surgery in the previous month. * Patients with an ostomy. * Patients with known colorectal cancer who had not undergone surgery.

Locations (1)

Hospital Universitari Germans Trias i Pujol

Badalona, Spain

Outcomes

Primary Outcomes

Safe Discharge

Patients with lower gastrointestinal bleeding and absence of all the following: rebleeding, re-consulting for LGIB within 28 days after discharge, in-hospital mortality, requirement of red blood cell transfusion or endoscopic, radiological, or surgical haemostatic treatment.

Time frame: After 1 month of follow-up from the hospital discharge

Validation of SHA2PE score in our cohort

We aim to validate this score in a southern Europe cohort and compare it to the Oakland score

Time frame: After 1 month of follow-up from the hospital discharge

Secondary Outcomes

Performance of Oakland score in safe discharge

We calculated the sensibility, specificity, positive and negative predictive values of the Oakland score in our patients cohort.

Time frame: After 1 month of follow-up from the hospital discharge

Performance of SHA2PE score in safe discharge

We calculated the sensibility, specificity, positive and negative predictive values of the SHA2PE score in our patients cohort.

Time frame: After 1 month of follow-up from the hospital discharge

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.