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The impact of a multidisciplinary algorithmic approach to acute lower gastrointestinal bleeding

      Acute lower gastrointestinal bleeding (LGIB) is associated with significant morbidity and mortality and is a leading cause for presentation to the emergency department (ED) [
      • Longstreth G.F.
      Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population-based study.
      ,
      • Strate L.
      • Gralnek I.
      Management of patients with acute lower gastrointestinal bleeding.
      ,
      • Peery A.
      • Crockett S.
      • Murphy C.
      • et al.
      Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2018.
      ,
      • Ciccocioppo A.
      • Walker M.
      • Taylor F.
      • et al.
      Protocol management for patients presenting with lower GI haemorrhage saves costs and maintains outcomes.
      ]. LGIB is responsible for >160,000 hospitalizations in the US every year, costing nearly $1.5 billion annually [
      • Peery A.
      • Crockett S.
      • Murphy C.
      • et al.
      Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2018.
      ]. Standardized treatment algorithms for LGIB have been associated with improved outcomes [
      • Ciccocioppo A.
      • Walker M.
      • Taylor F.
      • et al.
      Protocol management for patients presenting with lower GI haemorrhage saves costs and maintains outcomes.
      ,
      • Patel R.
      • Clancy R.
      • Crowther E.
      • Vannahme M.
      • Pullyblank A.
      A rectal bleeding algorithm can successfully reduce emergency admissions.
      ]. We therefore sought to improve the care of patients presenting to our ED with LGIB by developing and testing a standardized, multidisciplinary evaluation and management algorithm.

      Abbreviations:

      BMC (Boston Medical Center), ED (emergency department), IR (Interventional radiology), LGIB (lower gastrointestinal bleed)

      Keywords

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