Adherence to Guidelines: A National Audit of the Management of Acute upper Gastrointestinal Bleeding. The REASON Registry

Lu, Yidan; Barkun, Alan N.; Martel, Myriam

doi:10.1155/2014/252307

Cited by 36 publications

(25 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similarly, other contemporary studies from Australia and Europe have also reported high rates of non‐ulcer‐related bleeding, exceeding peptic ulcer disease . Even in studies where ulcer‐related bleeding was the most common cause, more than a third of cases were still from non‐ulcer‐related aetiologies . As such, non‐ulcer‐related bleeding is important, and to our knowledge, this is the largest study to date reporting on outcomes after non‐ulcer‐related NVUGIB and their determinants.…”

Section: Discussionmentioning

confidence: 57%

Comparative outcomes in patients with ulcer‐ vs non‐ulcer‐related acute upper gastrointestinal bleeding in the United Kingdom: a nationwide cohort of 4474 patients

Sey

Mohammed

Brahmania

et al. 2019

Aliment Pharmacol Ther

View full text Add to dashboard Cite

Background: Outcomes after Nonvariceal upper gastrointestinal bleeding (NVUGIB)have historically focused on ulcer-related causes. Little is known regarding non-ulcer bleeding, the most common cause of NVUGIB. Aim:To compare outcomes between ulcer-and non-ulcer-related NVUGIB and explore whether these could be explained by differences in baseline characteristics, bleeding severity or processes of care.Methods: Analysis of 4474 patients with NVUGIB from 212 United Kingdom hospitals as part of a nationwide audit. Logistic regression models were used to adjust for baseline characteristics, bleeding severity and processes of care.Results: 1682 patients had ulcer-related and 2792 patients had non-ulcer-related bleeding. Those with ulcer-related bleeding were older (median age 73 vs 69, P < 0.001), less likely to have been taking a PPI (18% vs 32%, P < 0.001), more likely to have been taking aspirin (40% vs 27%, P < 0.001) and present with shock (43% vs 32%, P < 0.001). Furthermore, those with ulcer-related bleeding were more likely to receive blood transfusion (66% vs 39%, P < 0.001), PPI infusion (27% vs 5%, P < 0.001) and endoscopic therapy (37% vs 8%, P < 0.001). Overall, ulcer-related bleeding had higher odds of in-hospital mortality (OR: 1.54; 95% CI:1.21-1.96, P < 0.0001), rebleeding (OR: 2.08; 95% CI: 1.73-2.51, P < 0.0001) and need for surgical/radiologic intervention (OR: 2.64; 95% CI: 1.85-3.77, P < 0.0001).The associations disappeared after adjustment for bleeding severity, whereas adjustment for patient characteristics or process of care factors had no impact. Conclusion:Patients with ulcer-related NVUGIB bleeding have worse outcomes than those with non-ulcer-related NVUGIB bleeding, which is due to more severe bleeding.Michael Sai Lai Sey and Seid B. Mohammed share co-first authorship. Brennan C. Kahan and Vipul Jairath share co-last authorship.

show abstract

Section: Discussionmentioning

confidence: 57%

Comparative outcomes in patients with ulcer‐ vs non‐ulcer‐related acute upper gastrointestinal bleeding in the United Kingdom: a nationwide cohort of 4474 patients

Sey

Mohammed

Brahmania

et al. 2019

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…Geographic differences in Helicobacter pylori colonization and susceptibility have previously been described [26]. In addition, there is clearly a variation in the way in which endoscopists manage upper gastrointestinal bleeding [27]. …”

Section: Discussionmentioning

confidence: 99%

Absence of Complications after Endoscopic Mucosal Biopsy

Johnson¹,

Basson²

2018

Dig Dis

View full text Add to dashboard Cite

Background: There is no clarity with regard to the occurrence of serious complications from EGD-driven mucosal biopsy. This is important for considering both clinically indicated procedures and mucosal sampling for research. Methods: We sought to quantify rates of serious complications from esophagogastroduodenoscopy (EGD) with biopsy. We studied 13,233 patients undergoing outpatient EGD with biopsy over 5 years in 2 North Dakota community hospitals, based on the reasoning that serious complications would cause hospitalization within 30 days. We reviewed the records of all patients with a diagnostic or procedure code or admission within 30 days after the outpatient EGD with biopsy. Results: Of the 13,233 patients who underwent outpatient EGD with biopsy, 411 were admitted within 30 days, most of them because of their underlying diagnosis. Two patients were admitted due to complications that resulted because of additional simultaneous procedures. No patient was admitted because of complications that could be ascribed to conscious sedation, upper GI endoscopic access, or mucosal biopsy. Conclusions: These data confirm that EGD biopsy is safe within community settings and suggest that the risk/benefit ratio for performing EGD biopsy for research is likely to be favorable if the research has scientific merit. Serious complications or perforation following EGD biopsy did not occur in 13,233 patients in community hospitals in North Dakota.

show abstract

“…Estos niveles de adherencia y su variabilidad no son diferentes de lo publicado internacionalmente respecto de la adherencia a recomendaciones en distintas áreas clínicas 19,20 . Esta similitud con otros estudios sumada a la concordancia satisfactoria en la auditoria "doble" realizada a una submuestra de los registros apoya la confiabilidad en las mediciones de adherencia realizadas en el estudio.…”

Section: Principales Hallazgosunclassified

Atributos de las guías clínicas del régimen de garantías en salud relacionados con su adopción en la atención primaria: una evaluación en 3 centros de salud familiar

2017

View full text Add to dashboard Cite

show abstract

Adherence to Guidelines: A National Audit of the Management of Acute upper Gastrointestinal Bleeding. The REASON Registry

Abstract: There was variability between the process of care and 'best practice' in NVUGIB. Certain patient and situational characteristics may influence guideline adherence. Dissemination initiatives must identify and focus on such considerations to improve quality of care.

Cited by 36 publications

References 28 publications

Comparative outcomes in patients with ulcer‐ vs non‐ulcer‐related acute upper gastrointestinal bleeding in the United Kingdom: a nationwide cohort of 4474 patients

Comparative outcomes in patients with ulcer‐ vs non‐ulcer‐related acute upper gastrointestinal bleeding in the United Kingdom: a nationwide cohort of 4474 patients

Absence of Complications after Endoscopic Mucosal Biopsy

Atributos de las guías clínicas del régimen de garantías en salud relacionados con su adopción en la atención primaria: una evaluación en 3 centros de salud familiar

Contact Info

Product

Resources

About