Dec 17, 2008

Health - UK;Bleeding test could free up beds

Doctors have developed a new technique to diagnose internal bleeding which could help free up hospital beds and save the NHS nearly £14m each year.

Clinicians at Glasgow Royal Infirmary created a scoring system to identify the seriousness of each case.

Patients with a Glasgow Blatchford Score (GBS) of zero are assessed as low-risk and can be allowed home.

Those with a score above zero are considered to be higher risk and can be kept in for observation.

GBS uses a combination of a patient's history, examination and laboratory tests to determine the level of risk.

On arriving at hospital, patients will be given two blood tests, have their pulse and blood pressure checked, and be asked whether they have had dizziness or a history of heart or liver problems.

The results then inform their GBS score and the course of action taken by doctors.

GBS is based on initial work by Dr Oliver Blatchford, a Glasgow-based consultant epidemiologist working in NHS Health Protection Scotland.
He developed a scoring system a few years ago which was tested in a 12-month study with 676 patients across the UK.

The study was led by Dr Adrian Stanley, consultant gastroenterologist at Glasgow Royal Infirmary, and involved Ninewells Hospital in Dundee, Royal Cornwall Hospital in Truro and University Hospital of North Tees in Stockton.

Dr Stanley said the potential benefits to the NHS of using GBS could be far-reaching.

"Most patients would rather avoid coming into hospital unless absolutely necessary but accurate identification of patients who do not require in-patient management is critical," he said.

'Focus resources'

"With the GBS, patients can be assessed quickly and accurately in A&E.

"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 in-patient admission."

About 51,000 patients attend hospital each year in the UK with symptoms of internal bleeding, from vomiting small amounts of blood to major bleeding.

Most are admitted before doctors can determine how severe their condition is, and many undergo an endoscopy.

The GBS study found many of the hospital admissions were unnecessary, and that 22% of people could have been treated as outpatients, saving the NHS up to £13.6m.

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