Lower GI bleeding is a common reason for emergency hospital admission, although there is paucity of data on presentations, interventions and outcomes.
In this nationwide UK audit, Dr Kathryn Oakland and colleagues described patient characteristics, interventions including endoscopy, radiology and surgery as well as clinical outcomes.
The research team perfored a multicentre audit of adults presenting with lower GI bleeding to UK hospitals over 2 months in 2015.
Consecutive cases were prospectively enrolled by clinical teams and followed for 28 days.
Data on 2528 cases of lower GI bleeding were provided by 143 hospitals.
The researchers observed that most were elderly with major comorbidities, 29% taking antiplatelets and 16% anticoagulants.
|48% patients underwent no inpatient investigations|
|American Journal of Gastroenterology|
Shock was uncommon, but 26% received a red cell transfusion.
The team noted that flexible sigmoidoscopy was the most common investigation but only 2% received endoscopic haemostasis.
Use of embolization or surgery was rare, used in less than 1% of cases.
The research team found that 48% of patients underwent no inpatient investigations.
The team observed that the most common diagnoses were diverticular bleeding and benign anorectal conditions.
Median length of stay was 3 days, 14% of patients rebled during admission, and 4% were readmitted with bleeding within 28 days.
In-hospital mortality was 3%, and was highest in established inpatients, and in patients experiencing rebleeding.
Dr Oakland's team concludes, "Patients with lower GI bleeding have a high burden of comorbidity and frequent antiplatelet or anticoagulant use."
"Red cell transfusion was common but most patients were not shocked and required no endoscopic, radiological or surgical treatment."
"Nearly half were not investigated."
"In-hospital mortality was related to comorbidity, not severe hemorrhage."