TPTh 2.14 Enhancing Guideline Adherence in Lower Gastrointestinal Bleeding Through Structured Risk Stratification: A Two-Cycle Audit

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ID: 324070
2026
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Abstract
Abstract Aim The aim of the audit was to assess local adherence to BSG risk stratification guidance in lower GI bleeding and evaluate the impact of a targeted educational intervention on clinical documentation and risk scoring practices. Methods A retrospective two-cycle audit was conducted over twelve-month periods in an acute tertiary hospital. Adult patients presenting with lower gastrointestinal bleeding were included (Cycle 1: n=66; Cycle 2: n=57). Data collected included Shock Index documentation, Oakland score calculation, admission status, and discharge suitability. A targeted educational intervention was introduced between cycles, and outcomes were re-audited to assess changes in risk stratification, admission practice, and resource utilisation. Results In Cycle 1, Shock Index was calculated in 27% of patients (18/66), and Oakland score in 36% (24/66). Overall admission rate was 53% (35/66). Among admitted patients, 44% (15/35) had Oakland scores consistent with safe discharge, indicating potentially avoidable admissions and associated financial cost to the hospital. In Cycle 2, SI calculation increased to 82% (47/57), and Oakland score use to 79% (45/57). Admission rate reduced to 38% (22/57). Among admitted patients, only 18% (4/22) had Oakland scores consistent with safe discharge, demonstrating improved patient selection, more appropriate admission decision-making, and better utilisation of inpatient resources. Conclusion Targeted, low-resource educational interventions improved compliance with national LGI bleeding risk stratification guidance. Routine use of Shock Index and Oakland scoring supported safer clinical decisions, enabling early escalation, appropriate discharge, reduced avoidable admissions, and meaningful cost savings while maintaining patient safety.
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Authors Dhiman Kanti Sikder, Gobinda Chandra Saha, Debashis Dey
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.439
URL
https://doi.org/10.1093/bjs/znag087.439
Keywords Keywords not found

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