Management of per rectal bleeding is resource intensive
Kar Yin Fok1, Jothi R Murugesan1, Richard Maher2
1Department of Colorectal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.
ANZ Journal of Surgery
|March 20, 2019
Summary
Per rectal (PR) bleeding, a common lower gastrointestinal bleed, requires significant hospital resources. This study highlights the intensive management and resource allocation needed for patients presenting with PR bleeding.
Area of Science:
- Gastroenterology
- Clinical Resource Management
Background:
- Per rectal (PR) bleeding is the most frequent clinical manifestation of lower gastrointestinal bleeding.
- The management of patients with PR bleeding necessitates substantial hospital resources.
Purpose of the Study:
- To analyze the hospital resources utilized in managing patients presenting with per rectal bleeding.
- To identify objective factors influencing resource utilization and patient outcomes.
Main Methods:
- Retrospective analysis of 523 patients with PR bleeding from June 2012 to December 2013.
- Recorded patient demographics, comorbidities, medications, vital signs, and hematological data.
- Analyzed relationships between initial assessment factors and outcomes like imaging, transfusion, endoscopy, surgery, and length of stay.
Main Results:
- 19% of patients received blood transfusions, 13% underwent CT mesenteric angiography, 4% had embolization, and 13% had colonoscopy.
- Referred patients had higher comorbidity (55% vs. 30%), increased antiplatelet/anticoagulant use (69% vs. 33%), higher embolization rates (28% vs. 4%), and longer hospital stays (7.9 vs. 5.7 days).
- Mortality remained consistent at 1% across groups.
Conclusions:
- Management of per rectal bleeding is resource-intensive.
- Improved resource allocation and identification of high-risk patients can enhance efficiency in managing this growing clinical issue.
Related Concept Videos
01:22Bleeding in Fresh Concrete
567
Bleeding in fresh concrete occurs when water from the mix rises to the surface. This happens because the mix's solid components fail to retain all the water as they settle, leading to separation where water collects at the top. The severity of bleeding can be measured by assessing the total settlement or by noting the decrease in height per unit height of concrete.
Bleeding can cause several issues in the concrete structure. Sometimes, the rising water gets trapped beneath large aggregate...
Bleeding can cause several issues in the concrete structure. Sometimes, the rising water gets trapped beneath large aggregate...
567
02:12Short-distance Transport of Resources
17.6K
Short-distance transport refers to transport that occurs over a distance of just 2-3 cells, crossing the plasma membrane in the process. Small uncharged molecules, such as oxygen, carbon dioxide, and water, can diffuse across the plasma membrane on their own. In contrast, ions and larger molecules require the assistance of transport proteins due to their charge or size. Transport across membranes also occurs within individual cells, playing a variety of essential roles for the plant as a whole.
17.6K
01:27Assessing Body Temperature - Rectal
11.9K
Rectal temperature measurement is considered the most precise method for assessing core body temperature and typically registers higher than oral temperature. For adults, the rectal thermometer should be inserted 1 to 1.5 inches into the rectum to obtain the most accurate reading.
Follow these steps for rectal temperature assessment:
Step 1: Perform hand hygiene and don clean gloves to prevent cross-infection.
Step 2: Position the patient in a side-lying position to better visualize the rectal...
Follow these steps for rectal temperature assessment:
Step 1: Perform hand hygiene and don clean gloves to prevent cross-infection.
Step 2: Position the patient in a side-lying position to better visualize the rectal...
11.9K
00:58Sound Intensity
4.8K
The loudness of a sound source is related to how energetically the source is vibrating, consequently making the molecules of the propagation medium vibrate. To measure the loudness of a source, the physical quantity of interest is the intensity. This is defined as the energy emitted per unit of time per unit of area perpendicular to the sound wave's propagation direction. Since the total energy is greater if the source vibrates for a longer duration and over a larger area, dividing the...
4.8K
00:53Sound Intensity Level
4.9K
Humans perceive sound by hearing. The human ear helps sound waves reach the brain, which then interprets the waves and creates the perception of hearing. The loudness of the environment in which a person is located determines whether they can distinguish between different sound sources.
The human ear can perceive an extensive range of sound intensity, necessitating the use of the logarithmic scale to define a physical quantity—the intensity level. It is a ratio of two intensities and...
The human ear can perceive an extensive range of sound intensity, necessitating the use of the logarithmic scale to define a physical quantity—the intensity level. It is a ratio of two intensities and...
4.9K
01:22Intensity Of Electromagnetic Waves
5.8K
The energy transport per unit area per unit time, or the Poynting vector, gives the energy flux of an electromagnetic wave at any specific time. For a plane electromagnetic wave with E0 and B0 as the peak electric and magnetic fields and traveling along the x-axis, the time-varying energy flux can be given by the following equation:
5.8K