医学
食管胃十二指肠镜检查
静脉曲张
内窥镜检查
急诊科
食管静脉曲张
回顾性队列研究
内科学
急诊医学
门脉高压
肝硬化
精神科
作者
Joana Alves da Silva,Daniela Falcão,Luís Maia,Tiago Pereira Guedes,Mónica Garrido,Maria Inês Novo,Mário de Seixas Rocha,Pedro Pinto,Teresa Moreira,Joana Ferreira,Isabel Pedroto
标识
DOI:10.1016/j.dld.2021.07.004
摘要
The extent to which patients with acute variceal bleeding (AVB) receive recommended care is largely unknown.to evaluate the adherence of the 4 major Baveno VI recommendations [vasoactive agents, prophylactic antibiotic, esophagogastroduodenoscopy (EGD) within 12 hours, endoscopic variceal ligation (EVL)] as a marker of quality of an emergency model.Retrospective evaluation of AVB admissions to a tertiary centre in which endoscopy was available 24hours-a-day, with a regional out-of-hours service at night (the furthest hospital is 200Km away). Patients were divided in directly admitted or transferred from other centres.210 AVB patients were included; 101 (48.1%) were directly admitted. The majority of patients were submitted to vasoactive agents (85.7%) and prophylactic antibiotics (79%) before EGD. In 178 patients (84.8%) endoscopy was performed within 12h and EVL was the procedure of choice in 116 (74.8%) (only oesophageal varices). No significant differences were observed between directly admitted and transferred patients in adherence rates. Overall rebleeding rate was 8.6%, in-hospital mortality 11.4% and 6-week mortality 20%.Adherence to quality metrics was high which might have played a vital role for reported outcomes. These results suggest that this model of care, provides accessibility and equity in access to urgent endoscopy.
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