TBA (24W148)

Time to Endoscopy in Patients Presenting with an Upper Gastrointestinal Bleed at a Tertiary Endoscopy Centre

Author(s)

Dr R Hughes, Dr A Kelly, Dr T Matthews, Dr B Kelleher, Professor S Stewart, Dr N Ramlaul, Dr J Leyden, Dr C Lahiff, Dr J Campion, Dr G Bennett, Dr O Craig

Department(s)/Institutions

Department of Gastroenterology, Mater Misericordiae University Hospital, Dublin 7

Introduction

The European Society of Gastrointestinal Endoscopy(ESGE) recommends early endoscopy in both nonvariceal(<24 hours) and variceal(<12 hours) bleed presentations. Despite evidence-based guidance on the management of UGIB, variability between hospitals and local protocols exist.

Aims/Background

We sought to evaluate the average time from admission to endoscopy for those presenting with an UGIB to MMUH over a 9 year period(2015-2023) and to investigate factors influencing their time to endoscopy.

Method

The MMUH HIPE database was interrogated for patients with a discharge diagnosis pertaining to UGIB and this was cross-referenced with the inpatient endoscopy database (EndoRAAD).

Results

From 2015-2023, 1002 UGIBs were identified. 403(40.2%) were female and the average age was 64 years(SD=17.7). The median day for endoscopy was on day 2 of admission and 662 patients(66%) had endoscopy within the first two days of admission regardless of Glasgow-Blatchford score. The number of OGDs for UGIB was found to be increasing on average by 9% per year(R2=0.32). There was no difference in gender for time to OGD(p=0.26). Neither age(p=0.18) nor gender(p=0.26) had an impact on time to OGD. Patients admitted on Friday(p<0.005) or Saturday(p<0.005) had a longer time to OGD than other days of the week.

Conclusions

MMUH endoscopy is performing well but not entirely adherent to current ESGE guidelines when evaluating those with UGIB. The majority of patients had an OGD performed by day 2 of admission. Age and gender did not impact the time to endoscopy. Increasing presentations with UGIB necessitates a commitment to continue to resource endoscopy at MMUH to reach ESGE standards.