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Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital
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 th...
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| Format: | Thesis |
| Language: | English |
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Department of Surgery
2020
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| _version_ | 1867613201708875776 |
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| access_status_str | Open Access |
| author | Aborkis, Ismail |
| author2 | Rayamajhi, Shreya |
| author_browse | Aborkis, Ismail Rayamajhi, Shreya |
| author_facet | Rayamajhi, Shreya Aborkis, Ismail |
| author_sort | Aborkis, Ismail |
| collection | Thesis |
| description | 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). |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/31453 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:21.936Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | Department of Surgery |
| publisherStr | Department of Surgery |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/31453 Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital Aborkis, Ismail Rayamajhi, Shreya Thomson, Sandie surgery 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). 2020-03-03T10:50:19Z 2020-03-03T10:50:19Z 2019 2020-03-03T10:49:37Z Master Thesis Masters MMed http://hdl.handle.net/11427/31453 eng application/pdf Department of Surgery Faculty of Health Sciences |
| spellingShingle | surgery Aborkis, Ismail Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital |
| thesis_degree_str | Master's |
| title | Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital |
| title_full | Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital |
| title_fullStr | Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital |
| title_full_unstemmed | Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital |
| title_short | Upper gastrointestinal bleed: a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit, Groote Schuur Hospital |
| title_sort | upper gastrointestinal bleed a comparative outcomes study of pre and post implementation of management guidelines in the acute care surgery unit groote schuur hospital |
| topic | surgery |
| url | http://hdl.handle.net/11427/31453 |
| work_keys_str_mv | AT aborkisismail uppergastrointestinalbleedacomparativeoutcomesstudyofpreandpostimplementationofmanagementguidelinesintheacutecaresurgeryunitgrooteschuurhospital |