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Using a practice guideline for safely shortening hospital stay for upper gastrointestinal tract hemorrhage

Article Abstract:

Practice guidelines that focus on shortening a patient's stay in the hospital need to be carefully tested to make sure early discharge does not affect the patient adversely. Practice guidelines are developed to encourage doctors to use diagnostic and therapeutic techniques that have been shown to work in clinical trials. A 1997 study reported that one practice guideline was able to predict which patients with upper gastrointestinal bleeding were at low risk of a recurrence and could be discharged early. Patients discharged early had no higher risk of health problems than a group who remained in the hospital longer.

Author: Cook, Deborah J., Peterson, Walter L.
Publisher: American Medical Association
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1997
Editorial

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Prospective evaluation of a clinical guideline recommending hospital length of stay in upper gastrointestinal tract hemorrhage

Article Abstract:

A clinical practice guideline that assigns a score to patients with an upper gastrointestinal bleed to predict their risk of recurring bleeding may save money and reduce resource use. The guideline combines physical characteristics seen on endoscopy with several other factors. Using the guideline, 70% of the 299 patients with an upper GI bleed were found to be at low risk of a recurrence. This reduced the average length of stay from 4.6 days to 2.9 days. No differences in health were seen one month later between this group and a group of patients not treated with the guideline.

Author: Ellrodt, A. Gray, Weingarten, Scott R., Hay, Jeffrey A., Maldonado, Lawrence
Publisher: American Medical Association
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1997

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Antisecretory Therapy for Bleeding Peptic Ulcer

Article Abstract:

Proton pump inhibitors may be effective in preventing rebleeding of ulcers. These drugs may be more effective than H2 receptor blockers, which are the traditional drug treatment for ulcers. Most patients with ulcers are infected with the bacterium Helicobacter pylori, and proton pump inhibitors are one of the drugs used to eradicate this organism. Endoscopy can also be effective in treating a bleeding ulcer. The endoscope can also reveal whether a clot has formed on the ulcer. If so, the best treatment is one that stabilizes the blood clot.

Author: Cook, Deborah J., Peterson, Walter L., Siegel, Ronna Henry
Publisher: American Medical Association
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1998
Prevention, Drug therapy, Peptic ulcer, Omeprazole

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Subjects list: Care and treatment, Evaluation, Gastrointestinal bleeding, Gastrointestinal hemorrhage, Practice guidelines (Medicine), Hospital utilization, Hospital stays
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