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Titolo:
Endoscopy-based triage significantly reduces hospitalization rates and costs of treating upper GI bleeding: a randomized controlled trial
Autore:
Lee, JG; Turnipseed, S; Romano, PS; Vigil, H; Azari, R; Melnikoff, N; Hsu, R; Kirk, D; Sokolove, P; Leung, JW;
Indirizzi:
Univ Calif Davis, Med Ctr, Div Gastroenterol Gen Med & Emergency Med, Sacramento, CA 95817 USA Univ Calif Davis Sacramento CA USA 95817 cy Med, Sacramento, CA 95817 USA
Titolo Testata:
GASTROINTESTINAL ENDOSCOPY
fascicolo: 6, volume: 50, anno: 1999,
pagine: 755 - 761
SICI:
0016-5107(199912)50:6<755:ETSRHR>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
UPPER GASTROINTESTINAL HEMORRHAGE; PEPTIC-ULCERS; OUTPATIENT CARE; THERAPY; VESSEL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Lee, JG Univ Calif Davis, Med Ctr, Div Gastroenterol, 4150 V St,Room 3500,Sacramento, CA 95817 USA Univ Calif Davis 4150 V St,Room 3500 Sacramento CA USA 95817 7 USA
Citazione:
J.G. Lee et al., "Endoscopy-based triage significantly reduces hospitalization rates and costs of treating upper GI bleeding: a randomized controlled trial", GASTROIN EN, 50(6), 1999, pp. 755-761

Abstract

Background: Many patients with upper gastrointestinal (GI) bleeding have abenign outcome and could receive less intensive and costly care if accurately identified. We sought to determine whether early endoscopy performed shortly after admission in the emergency department could significantly reduce the health care use and costs of caring for patients with nonvariceal upper GI bleeding without adversely affecting the clinical outcome. Methods: All eligible patients with upper GI bleeding and stable vital signs were randomized after admission to undergo endoscopy in 1 to 2 days (control) or early endoscopy in the emergency department. Patients with low-risk findings on early endoscopy were discharged directly from the emergency department. Clinical outcomes and costs were prospectively assessed for 30 days. Results: We randomized 110 consecutive stable patients with nonvariceal upper GI bleeding during the 12-month study period. The baseline demographic features, endoscopic findings, and the clinical outcomes were no different between the two groups. However the findings of the early endoscopy allowedus to immediately discharge 26 of 56 (46%) patients randomized to that group. No patient discharged from the emergency department suffered an adverseoutcome. The hospital stay (median of 1 day [interquartile range of 0 to 3days] vs. 2 days [interquartile range of 2 to 3 days], p = 0.0001) and thecost of care ($2068 [interquartile range of $928 to $3960] versus $3662 [interquartile range of $2473 to $7280], p = 0.00006) were significantly lessfor the early endoscopy group. Conclusions: Early endoscopy performed shortly after admission in the emergency department safely triaged 46% of patients with nonvariceal upper GI bleeding to outpatient care, which significantly reduced hospital stay and costs.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/08/20 alle ore 23:35:14