Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital

dc.contributor.advisorRayamajhi, Shreya
dc.contributor.advisorThomson, Sandie
dc.contributor.authorAborkis, Ismail
dc.date.accessioned2020-03-03T10:50:19Z
dc.date.available2020-03-03T10:50:19Z
dc.date.issued2019
dc.date.updated2020-03-03T10:49:37Z
dc.description.abstractBackground: Upper gastrointestinal bleeding (UGIT) is a common presentation to hospital and can result in a significant morbidity, mortality and hospital costs. Consensus guidelines are present from various international expert bodies regarding the management of these patients and compliance with these guidelines is variable and is dependent on rigorous implementation and continuous audits. Aim: The primary aim of this study is to evaluate complaints to three aspects of management of UGITB (time of endoscopy ,use of dual endotherapy and haemoglubin trigger for transfusion) at Acute Care Surgery Unit, at Groote Schuur Hospital. Methods: This is a comparative study between a retrospective control group and a prospective cohort post implementation of a quality improvement program (QIP). Results: This study included 109 patients, 51 in the control and 58 in the QIP group. The two groups were statistically comparable in terms of demographics, clinical presentation, referral pattern and endoscopy finding. Over 80% in both groups had their endoscopy within 24 hours (Control 83.7%, QIP 81.6%). Time to endoscopy was not statistically significantly different between the Control and QIP groups for low and high-risk patients ((suspected varices or Modified Glasgow-Blatchford Score (MBS) >10)). However, when both groups are combined, patients with an MBS of >10 or more had a statistically shorter 'Time to scope’ by 8 hours than those with a score < 10 (p=0.02).
dc.identifier.apacitationAborkis, I. (2019). <i>Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital</i>. (). ,Faculty of Health Sciences ,Department of Surgery. Retrieved from http://hdl.handle.net/11427/31453en_ZA
dc.identifier.chicagocitationAborkis, Ismail. <i>"Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital."</i> ., ,Faculty of Health Sciences ,Department of Surgery, 2019. http://hdl.handle.net/11427/31453en_ZA
dc.identifier.citationAborkis, I. 2019. Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital. . ,Faculty of Health Sciences ,Department of Surgery. http://hdl.handle.net/11427/31453en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Aborkis, Ismail AB - Background: Upper gastrointestinal bleeding (UGIT) is a common presentation to hospital and can result in a significant morbidity, mortality and hospital costs. Consensus guidelines are present from various international expert bodies regarding the management of these patients and compliance with these guidelines is variable and is dependent on rigorous implementation and continuous audits. Aim: The primary aim of this study is to evaluate complaints to three aspects of management of UGITB (time of endoscopy ,use of dual endotherapy and haemoglubin trigger for transfusion) at Acute Care Surgery Unit, at Groote Schuur Hospital. Methods: This is a comparative study between a retrospective control group and a prospective cohort post implementation of a quality improvement program (QIP). Results: This study included 109 patients, 51 in the control and 58 in the QIP group. The two groups were statistically comparable in terms of demographics, clinical presentation, referral pattern and endoscopy finding. Over 80% in both groups had their endoscopy within 24 hours (Control 83.7%, QIP 81.6%). Time to endoscopy was not statistically significantly different between the Control and QIP groups for low and high-risk patients ((suspected varices or Modified Glasgow-Blatchford Score (MBS) >10)). However, when both groups are combined, patients with an MBS of >10 or more had a statistically shorter 'Time to scope’ by 8 hours than those with a score < 10 (p=0.02). DA - 2019 DB - OpenUCT DP - University of Cape Town KW - surgery LK - https://open.uct.ac.za PY - 2019 T1 - Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital TI - Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital UR - http://hdl.handle.net/11427/31453 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/31453
dc.identifier.vancouvercitationAborkis I. Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital. []. ,Faculty of Health Sciences ,Department of Surgery, 2019 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/31453en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Surgery
dc.publisher.facultyFaculty of Health Sciences
dc.subjectsurgery
dc.titleUpper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMed
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