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Article
Impact of a bleeding care pathway in the management of acute upper gastrointestinal bleeding.
Indian Journal of Gastroenterology : official Journal of the Indian Society of Gastroenterology
  • Khalid Mumtaz, Aga Khan University
  • Lubna Kamani, Aga Khan University
  • Saeed Hamid, Aga Khan University
  • Shahab Abid, Aga Khan University
  • Hasnain A Shah, Aga Khan University
  • Wasim Jafri, Aga Khan University
Publication Date
3-1-2011
Document Type
Article
Disciplines
Abstract

Objectives: Upper gastrointestinal (UGI) bleeding carries high morbidity and mortality. The use of a bleeding care pathway (BCP) may improve outcomes, but the results are inconsistent in various studies.

Methods:

A BCP for Patients with UGI bleed with admission in a bleeding care unit (BCU) has been in use at our hospital since 2005. Prior to this, a high dependency unit was used for management of all emergencies including UGI bleeding. We compared the length of stay in the bleeding care/high dependency unit, total hospital stay, time to UGI endoscopy after admission, and survival between pre-2005 and post-2005 Patients.

Results:

Five hundred and fifty-one Patients were admitted with acute UGI bleed in the last 5 years, 121 belonged to pre-BCP (2004) period and 430 after implementation of the pathway (2005-2008). The mean (SD) time to UGI endoscopy improved from 21.3 (7.4) hours in the pre-BCU era to 9.4 (9.9) hours in BCU, p < 0.001. BCU stay was shorter from 2.41 (1.4) days pre-BCP to 1.93 (1.32) days post-BCP, (p < 0.001). The total hospital stay in pre-BCU (4.0 [2.08] days) as compared to BCU (4.13 [2.62] days, p = 0.58) was similar, there was no impact of BCU on survival.

Conclusion:

A BCU implementation showed improvement in time to UGI endoscopy, and did not reduce BCU stay or impact survival.

Citation Information
Khalid Mumtaz, Lubna Kamani, Saeed Hamid, Shahab Abid, et al.. "Impact of a bleeding care pathway in the management of acute upper gastrointestinal bleeding." Indian Journal of Gastroenterology : official Journal of the Indian Society of Gastroenterology Vol. 30 Iss. 2 (2011) p. 72 - 7
Available at: http://works.bepress.com/shahab_abid/22/