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Brief Report| Volume 37, ISSUE 9, P1751-1753, September 01, 2019

The impact of a multidisciplinary algorithmic approach to acute lower gastrointestinal bleeding

Published:June 21, 2019DOI:https://doi.org/10.1016/j.ajem.2019.06.034
The impact of a multidisciplinary algorithmic approach to acute lower gastrointestinal bleeding
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      Acute lower gastrointestinal bleeding (LGIB) is associated with significant morbidity and mortality and is a leading cause for presentation to the emergency department (ED) [
      • Longstreth G.F.
      Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population-based study.
      Am J Gastroenterol. 1997; 92: 419-424
      ,
      • Strate L.
      • Gralnek I.
      Management of patients with acute lower gastrointestinal bleeding.
      Am J Gastroenterol. 2016; 111: 459-474
      ,
      • Peery A.
      • Crockett S.
      • Murphy C.
      • et al.
      Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2018.
      Gastroenterology. 2019; 156: 254-272
      ,
      • Ciccocioppo A.
      • Walker M.
      • Taylor F.
      • et al.
      Protocol management for patients presenting with lower GI haemorrhage saves costs and maintains outcomes.
      ANZ J Surg. 2011; 81: 451-455
      ]. LGIB is responsible for >160,000 hospitalizations in the US every year, costing nearly $1.5 billion annually [
      • Peery A.
      • Crockett S.
      • Murphy C.
      • et al.
      Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2018.
      Gastroenterology. 2019; 156: 254-272
      ]. Standardized treatment algorithms for LGIB have been associated with improved outcomes [
      • Ciccocioppo A.
      • Walker M.
      • Taylor F.
      • et al.
      Protocol management for patients presenting with lower GI haemorrhage saves costs and maintains outcomes.
      ANZ J Surg. 2011; 81: 451-455
      ,
      • Patel R.
      • Clancy R.
      • Crowther E.
      • Vannahme M.
      • Pullyblank A.
      A rectal bleeding algorithm can successfully reduce emergency admissions.
      Colorectal Dis. 2014; 16: 377-381
      ]. We therefore sought to improve the care of patients presenting to our ED with LGIB by developing and testing a standardized, multidisciplinary evaluation and management algorithm.

      Abbreviations:

      BMC (Boston Medical Center), ED (emergency department), IR (Interventional radiology), LGIB (lower gastrointestinal bleed)

      Keywords

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      References

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        Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population-based study.
        Am J Gastroenterol. 1997; 92: 419-424
        View in Article
        • Strate L.
        • Gralnek I.
        Management of patients with acute lower gastrointestinal bleeding.
        Am J Gastroenterol. 2016; 111: 459-474
        View in Article
        • Peery A.
        • Crockett S.
        • Murphy C.
        • et al.
        Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2018.
        Gastroenterology. 2019; 156: 254-272
        View in Article
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        • Walker M.
        • Taylor F.
        • et al.
        Protocol management for patients presenting with lower GI haemorrhage saves costs and maintains outcomes.
        ANZ J Surg. 2011; 81: 451-455
        View in Article
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        • Clancy R.
        • Crowther E.
        • Vannahme M.
        • Pullyblank A.
        A rectal bleeding algorithm can successfully reduce emergency admissions.
        Colorectal Dis. 2014; 16: 377-381
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      Article Info

      Publication History

      Published online: June 21, 2019
      Accepted: June 20, 2019
      Received in revised form: June 17, 2019
      Received: March 15, 2019

      Identification

      DOI: https://doi.org/10.1016/j.ajem.2019.06.034

      Copyright

      © 2019 Elsevier Inc. All rights reserved.

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