ArticleThe journal of trauma and acute care surgery2017
Improved outcomes following implementation of an acute gastrointestinal bleeding multidisciplinary protocol.
Article in The journal of trauma and acute care surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Organizational models for acute gastrointestinal bleeding: a systematic review of hospital networks, multidisciplinary care and bloodless programs (2015-2025).Frontiers in medicine · 2026Pooled it
- Quality Improvement in Gastroenterology: A Systematic Review of Practical Interventions for Clinicians.Digestive diseases and sciences · 2018Pooled it
- Racial Disparities in Upper Gastrointestinal Hemorrhage Treatment.Journal of racial and ethnic health disparities · 2026Article
- Long-Term Outcomes following Acute Upper Gastrointestinal Bleeding Remain Poor: A Single-Center Comparison over Two Distinct Time Periods within the Last 15 Years in Finland.Visceral medicine · 2024Article
- Review of an emergency general surgery process improvement program at a verified military trauma center.Surgical endoscopy · 2018Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
backgroundEffective multidisciplinary management of gastrointestinal bleeding (GIB) requires effective communication. We instituted a protocol to standardize communication practices with the hypothesis that outcomes would improve following protocol initiation.
methodsWe performed a retrospective cohort analysis of 442 patients who required procedural management of acute GIB at our institution during a 50-month period spanning 25 months before and 25 months after implementation of a multidisciplinary communication protocol. The protocol stipulates that when a patient with severe GIB is identified, a conference call is coordinated among the gastroenterology, interventional radiology, and acute care surgery teams. A consensus plan is generated and then reassessed following procedural interventions and changes in patients' status. Patients' characteristics, management strategies, and outcomes were compared before and after protocol initiation.
resultsPatient populations before and after protocol initiation were similar in age, comorbidities, outpatient use of antiplatelet/anticoagulant medications, admission vital signs, and admission laboratory values. The median interval between admission and the first procedure was significantly shorter in the protocol group (40 vs 47 hours, p = 0.046). The proportion of patients who received packed red blood cell transfusions decreased following protocol initiation (41% vs 50%, p = 0.018). Median hospital length of stay was significantly shorter in the protocol group (5.0 vs 6.0 days, p = 0.014). Readmissions with GIB were decreased after protocol implementation (8% vs. 15%, p = 0.023).
conclusionImplementation of a multidisciplinary protocol for management of acute GIB was associated with earlier intervention, fewer packed red blood cell transfusions, shorter hospital length of stay, and fewer readmissions with GIB. Future research should seek to establish causal relationships between communication practices and outcomes. LEVEL OF EVIDENCE: Therapeutic study, level III.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.