Aims-To assess changes in practice and outcome in acute upper gastrointestinal haemorrhage following the feedback of data, the reemphasis of national guidelines, and specific recommendations following an initial survey.
Forty five hospitals from three health regions participed in two phases of the audit cycle.
2332 patients with acute upper gastrointestinal haemorrhage ; phase II : 1625 patients with upper gastrointestinal haemorrhage.
Methods-Patients were evaluated with respect to management (with reference to the recommendations in the national guidelines), mortality, and length of hospital stay.
Following the distribution of data from the first phase of the National Audit and the formulation of specific recommendations for improving practice, the proportion of hospitals with local guidelines or protocols for the management of upper gastrointestinal haemorrhage rose from 71% (32/45) to 91% (41/45) ; 12 of the 32 hospitals with guidelines during the first phase revised their guidelines following the initial survey.
There was a small but significant increase in the proportion of all patients who underwent endoscopy (from 81% to 86%), the proportion who underwent endoscopy within 24 hours of admission (from 50% to 56%), and the use of central venous pressure monitoring in patients with organ failure requiring blood transfusion or those with profound shock (from 30% to 43%). (...)
Mots-clés Pascal : Gastrointestinal, Extrémité supérieure, Etude multicentrique, Hémorragie, Aigu, Enquête publique, Conduite à tenir, Evaluation, Disposition pratique, Recommandation, Hôpital, Homme, Appareil digestif pathologie, Estomac pathologie, Intestin pathologie, Appareil circulatoire pathologie
Mots-clés Pascal anglais : Gastrointestinal, Upper extremity, Multicenter study, Hemorrhage, Acute, Public inquiry, Clinical management, Evaluation, Practical measure, Recommendation, Hospital, Human, Digestive diseases, Gastric disease, Intestinal disease, Cardiovascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0002217
Code Inist : 002B13B03. Création : 17/04/1998.