dc.contributor.author |
Chong, V |
en |
dc.contributor.author |
Hill, Andrew |
en |
dc.contributor.author |
MacCormick, Andrew |
en |
dc.date.accessioned |
2016-07-18T03:08:01Z |
en |
dc.date.issued |
2016-01 |
en |
dc.identifier.citation |
International Journal of Surgery, 2016, 25 pp. 19 - 23 |
en |
dc.identifier.issn |
1743-9191 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/29469 |
en |
dc.description.abstract |
Acute lower gastrointestinal bleeding (LGIB) is a common acute presenting complaint to hospital. Unlike upper gastrointestinal bleeding, the diagnostic and therapeutic approach is not well-standardised. Intensive monitoring and urgent interventions are essential for patients with severe LGIB. The aim of this study is to investigate factors that predict severe LGIB and develop a clinical predictor tool to accurately triage LGIB in the emergency department of a busy metropolitan teaching hospital.We retrospectively identified all adult patients who presented to Middlemore Hospital Emergency Department with LGIB over a one year period. We recorded demographic variables, Charlson Co-morbidities Index, use of anticoagulation, examination findings, vital signs on arrival, laboratory test results, treatment plans and further investigations results. We then identified a subgroup of patients who suffered severe LGIB.A total of 668 patients presented with an initial triage diagnosis of LGIB. 83 of these patients (20%) developed severe LGIB. Binary logistic regression analysis identified four independent risk factors for severe LGIB: use of aspirin, history of collapse, haemoglobin on presentation of less than 100 mg/dl and albumin of less than 38 g/l.We have developed a clinical prediction tool for severe LGIB in our population with a negative predictive value (NPV) of 88% and a positive predictive value (PPV) of 44% respectively. We aim to validate the clinical prediction tool in a further cohort to ensure stability of the multivariate model. |
en |
dc.format.medium |
Print-Electronic |
en |
dc.language |
eng |
en |
dc.publisher |
Elsevier |
en |
dc.relation.ispartofseries |
International Journal of Surgery |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.title |
Accurate triage of lower gastrointestinal bleed (LGIB) - A cohort study |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1016/j.ijsu.2015.11.003 |
en |
pubs.begin-page |
19 |
en |
pubs.volume |
25 |
en |
dc.rights.holder |
Copyright:
Elsevier |
en |
dc.identifier.pmid |
26612527 |
en |
pubs.end-page |
23 |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Article |
en |
pubs.elements-id |
515033 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
South Auckland clinical school |
en |
pubs.org-id |
Surgery Department |
en |
dc.identifier.eissn |
1743-9159 |
en |
pubs.record-created-at-source-date |
2016-07-18 |
en |
pubs.dimensions-id |
26612527 |
en |