Study could reduce needless admissions

The GBS has shown that many of those admissions are unnecessary and found that 22% of patients with internal bleeding can be safely treated as outpatients instead. It is estimated that the scoring system could save between 60,000 to 100,000 hospital bed days every year in UK hospitals and experts have calculated that it could save the NHS £13.6 million per year. Dr Adrian Stanley, the consultant gastroenterologist at Glasgow Royal Infirmary who led the study, explained: “Internal bleeding, also known as upper gastrointestinal haemorrhage (UGIH), is a very common reason for hospital admission particularly in the West of Scotland. It can range from vomiting small amounts of blood to major bleeding. “Traditionally the vast majority of patients would be admitted and may undergo an endoscopy procedure, with or without further intervention if needed. However, the new scoring system is able to identify a low-risk group who do not require hospital admission or treatment but instead could come for an out-patient endoscopy at a later stage.” Dr Stanley and his colleagues put initial work by Dr Oliver Blatchford, a Glasgow based consultant epidemiologist working in NHS Health Protection Scotland, to the practical test in a study which involved 676 patients across the UK. Each patient was checked using the new GBS, to assess who was low-risk and did not need to stay in hospital for observation, exploratory tests, transfusions, invasive treatment or surgery. The GBS uses a combination of the patient’s history, examination and laboratory tests. When put into practice it found that 22% of patients presenting with UGIH did not require admission. Dr Stanley added: “Our data suggests that if the GBS was extended to all UK hospitals, up to 100 000 “bed-days” could be avoided for this condition each year. This would allow us to focus our resources and skills on those patients with more severe bleeding and other conditions who definitely do require inpatient admission.”