12^th Global Gastroenterologists Meeting

Gastrointestinal (GI) bleeding is one of the commonest medical emergencies. The incidence rate of 1.33/1000 population equates to approximately 85,000 cases/year in the UK or one gastrointestinal bleed every 6 minutes. National Institute of Clinical Excellence (NICE) guidelines have set standards on management of Acute GI bleeding in a timely fashion to reduce morbidity and mortality. The aim of this audit is to assess if there’s improvement to clinical practice compared to results from previous two years. Data was analysed retrospectively from a total of 33 case notes, randomly selected from a total of 594 case notes and all of which were diagnosed with upper GI bleeding from January to December 2016. Results have demonstrated that all patients had Blatchford score calculated, 100% had appropriate blood tests on admission, and no one received inappropriate blood products. 87.5% who were appropriate for Oesophago-gastroduodenoscopy (OGD) received endoscopy in less than 24 hours. The remaining 22.5% failed were due to Clostridium difficile infection and process failure. There was 0% mortality post endoscopy and no instances of rebleeding despite under calculation of Rockall score for these patients. Even though this is relatively a small sample size, it sufficiently concludes that the implemented changes according to national guidelines have

had positive impacts on the mortality and morbidity of patients admitted with acute upper GI haemorrhage. Not every patient received OGD in less than 24 hours after admission, but all had thorough clinical assessments and in cases where OGD was delayed, they had clear clinical reasoning on clinical grounds. However, standards were unmet for the same core reasons from previous audits, i.e. no clear instructions left from endoscopists for Rockall score to be calculated.