October 26, 2021
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Yen T, et al. Optimizing endoscopy action affidavit improves guideline adherent affliction in aerial gastrointestinal bleeding. Presented at: ACG Annual Scientific Meeting; Oct. 22-27, 2021; Las Vegas (hybrid meeting).
Disclosures: Yen letters no accordant banking disclosures.
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LAS VEGAS – A atypical guideline-based arrangement connected able affidavit and bigger analytic affliction afterwards esophagogastroduodenoscopy, according to analysis presented at ACG Annual Scientific Meeting.
“Upper gastrointestinal bleeding (UGIB) is a accepted adumbration for inpatient EGD,” Timothy Yen, MD, of the University of Colorado Anschutz Medical Campus, said during the presentation. “Outcomes afterwards accept generally been dependent, in part, by guideline-based post-EGD care.”
To optimize and assimilate affidavit afterwards EGD for UGIB care, Yen and colleagues congenital analysis and severity-specific agenda templates based on civic guidelines. They calm abstracts on pre-intervention and post-intervention “minimal-standard” abode affidavit on accommodating disposition, diet and medication as able-bodied as recorded affidavit of rebleed precautions and aftereffect procedures. Recorded bloom outcomes afterward arrangement administering included assigned medications, ordered aftereffect EGD and analytic abeyance of bleeding afterwards discharge. Included attendings (n = 39) and advisers (n = 15) underwent a 10-minute training affair on arrangement agreeable and use.
Prior to intervention, 108 patients accustomed either guideline-based inpatient proton pump inhibitors (54%) or outpatient PPIs (36%); baseline measures appear standard-of-care echo EGD amid 67.6% of patients with alone 36.1% of letters affair minimal-standard criteria.
Following arrangement accomplishing in 309 EGDs for UGIB, advisers acclaimed arrangement accessible in 72% of cases. The arrangement bargain workload and bigger affidavit of disposition (63%-74.1%), adapted PPI acceptance (57.1%-69.8%), rebleed advocacy (22.2%-44.3%) and minimal-standard abode achievement (27.8%-40.8%). Arrangement use additionally bigger inpatient PPI administering and acquiescence (53.6%-73.6% and 71.7% vs. 63.4%, respectively), acquittal PPI decree (35.7%-54%) and aftereffect EGD adjustment (85.7% vs. 77.3%).
“Our activity leveraged endoscopy software to assimilate able provider affidavit consistent in bigger analytic care,” Yen said. “Our action appropriate basal accomplishing costs, low accountability of aliment and sustainability with aerial appliance ante over the advance of 6 months. Similar endoscopy templates can be activated to added bloom systems and endoscopic procedures to advance the affection of care.”
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