A Prospective Multi-Centre Audit Predicting Patient Outcomes in Lower-GastroIntestinal Bleeding
Chief Investigator: Ed Fitzgerald, Specialist Registrar, General Surgery, Chelsea & Westminster NHS Hospital Trust
Lower gastrointestinal bleeding (LGIB) is a common manifestation of numerous gastrointestinal conditions. It has a lifetime incidence of approximately 15% in the Western world. Unlike UGI bleeding, there are currently no commonly accepted triaging models or scoring systems stratify patients. In most cases, bleeding from the colon and rectum is self-limiting, resulting from benign pathology, and requiring no specific therapy. However severe episodes may require more aggressive intervention and intensive care unit (ICU) admission.
We have previously undertaken a retrospective single-centre audit of simple clinical factors at admission and within 24-hours. Stepwise multivariate logistic regression analysis was utilised to identify predictive factors, with an area under the receiver operating characteristic curve for the resulting model of 0.79 (95% CI 0.70 – 0.90).
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Patients at high risk of adverse outcomes from LGIB can be predicted through simple, standard clinical variables recorded at admission and within the first 24-hours.
Prospective multi-centre audit to examine these identified predictors across a number of hospitals in a larger patient cohort. This study would benefit from a collaborative approach across a number of centres, and would ideally be co-ordinated by a steering group to oversee the project.
I am forming a steering committee to:
How to get involved
If you want to be involved either in the steering group or the data collection, send an email to edwardfitzgerald [at] doctors.org.uk
Those who have expressed an interest so far are:
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Ed's Lower GI Bleed Score