Factors Associated With Emergency Department Discharge, Outcomes and Follow-Up Rates of Stable Patients With Lower...

Area of Science:

• Gastroenterology
• Emergency Medicine
• Internal Medicine

Background:

• Lower gastrointestinal bleeding (LGIB) is a frequent cause of hospital admission.
• Emerging evidence suggests that low-risk LGIB patients may be safely managed as outpatients.
• This study compares outcomes of stable LGIB patients discharged from the emergency department (ED) versus those admitted.

Purpose of the Study:

• To compare stable LGIB patients discharged from the ED with those admitted.
• To identify factors associated with discharge decisions.
• To evaluate 30-day outcomes and outpatient follow-up rates in discharged patients.

Main Methods:

• Retrospective analysis of stable LGIB patients presenting to the ED.
• Defined stable patients by heart rate, blood pressure, and rectal exam findings.
• Compared outcomes (re-bleeding, re-admission, mortality) and follow-up rates between admitted and discharged groups.

Main Results:

• 38% of 97 stable LGIB patients were discharged.
• Discharge was associated with younger age, no aspirin/anticoagulant use, higher hemoglobin/albumin, lower BUN/creatinine, and lower Oakland/Charlson scores.
• No significant differences in 30-day re-bleeding, re-admission, or mortality rates between groups; 46% outpatient follow-up in discharged patients.

Conclusions:

• Early discharge for low-risk LGIB patients is safe and reduces length of stay.
• Further research is needed to optimize outpatient evaluation strategies for these patients.