title: Study protocol: first nationwide comparative audit of acute lower gastrointestinal bleeding in the UK.
abstract: Acute lower gastrointestinal bleeding (LGIB) is a common indication for emergency hospitalisation worldwide. In contrast to upper GIB, patient characteristics, modes of investigation, transfusion, treatment and outcomes are poorly described. There are minimal clinical guidelines to inform care pathways and the use of endoscopy, including (diagnostic and therapeutic yields), interventional radiology and surgery are poorly defined. As a result, there is potential for wide variation in practice and clinical outcomes.
  
  
  
  The UK Lower Gastrointestinal Bleeding Audit is a large nationwide audit of adult patients acutely admitted with LGIB or those who develop LGIB while hospitalised for another reason. Consecutive, unselected presentations with LGIB will be enrolled prospectively over a 2-month period at the end of 2015 and detailed data will be collected on patient characteristics, comorbidities, use of anticoagulants, transfusion, timing and modalities of diagnostic and therapeutic procedures, clinical outcome, length of stay and mortality. These will be audited against predefined minimum standards of care for LGIB. It is anticipated that over 80% of all acute hospitals in England and some hospitals in Scotland, Wales and Northern Ireland will participate. Data will be collected on the availability and organisation of care, provision of diagnostic and therapeutic GI endoscopy, interventional radiology, surgery and transfusion protocols.
  
  
  
  This audit will be conducted as part of the national comparative audit programme of blood transfusion through collaboration with specialists in gastroenterology, surgery and interventional radiology. Individual reports will be provided to each participant site as well as an overall report and disseminated through specialist societies. Results will also be published in peer-reviewed journals. The study has been funded by National Health Services (NHS) Blood and Transplant and the Bowel Disease Research Foundation and endorsed by the Association of Coloproctology of Great Britain and Ireland.
authors: NHS Blood and Transplant, UK.
authors: Kathryn
authors: K
authors: Oakland
authors: Department of Colorectal Surgery, Oxford University Hospitals, Oxford, UK.
authors: Richard
authors: R
authors: Guy
authors: Department of Interventional Radiology, Oxford University Hospitals, Oxford, UK.
authors: Raman
authors: R
authors: Uberoi
authors: NHS Blood and Transplant, UK.
authors: Frances
authors: F
authors: Seeney
authors: Nuffield Department of Orthopaedics, Centre for Statistics in Medicine, Botnar Research Centre, University of Oxford, Oxford, UK.
authors: Gary
authors: G
authors: Collins
authors: NHS Blood and Transplant, UK.
authors: John
authors: J
authors: Grant-Casey
authors: Department of Colorectal Surgery, Oxford University Hospitals, Oxford, UK.
authors: Neil
authors: N
authors: Mortensen
authors: NHS Blood and Transplant, UK.
authors: Mike
authors: M
authors: Murphy
authors: Department of Medicine, Division of Gastroenterology, Western University and London Health Sciences Centre, Ontario, Canada Nuffield Department of Medicine, University of Oxford, Oxford, UK.
authors: Vipul
authors: V
authors: Jairath
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D054869:Clinical Audit; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012107:Research Design; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult