a patient who should be routinely evaluated for peptic ulcer disease is one who is This is a topic that many people are looking for. bluevelvetrestaurant.com is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, bluevelvetrestaurant.com would like to introduce to you DDW 2009 Poster Session Screening for H Pylori Peptic Ulcer Hemmorhage. Following along are instructions in the video below:
Afternoon. Everyone so today im going to talk about my poster. Which is right right here.
The title is screening for. H pylori in. Hospitalized patients with upper gi as we know there are 150000.
People are hospitalized every year. Because of gi bleeding on one third to two third of these patients have gi bleeding. Because of pickles.
Sir because of h. Pylori. There is not good amount of data.
How many of these patients with peptic ulcer bleeding are screened. Routinely for h. Pylori.
Domestic. Three guidelines. Recommend everyone to be screened for h.
Pylori. If they have peptic ulcer all its complications such as peptic ulcer bleeding. So this study was undertaken as a chord study in our single institution to study how many patients with peptic ulcer bleeding over the last six years have been screened for h.
Pylori. So from our administrative data base for hospital. We took all patients with the primary or secondary diagnosis of peptic ulcer.
Bleeding and then we map those data to our administrative data base for endoscopy and through that we documented that these people in fact did have peptic ulcers. We excluded patients who had other causes of bleeding such as viruses or any tumor. After we identified.
Our population. Then we match our patient population with our electronic health record data to guide to get all. The lab data about h.
Pylori screening and also patient demographics. So for the results. We had a total of 189 patients that met the criteria of peptic ulcer bleeding and hospitalization who underwent endoscopy in our institution.
These patients did not have any other secondary cause for bleeding and what we found as shown in this pie chart around forty five percent did not have any screening at any given time of since the hospitalization and the length of follow up varied from six months to four years fifty five percent of the patients were screened for h pylori. According to guidelines. However as you can see the breakdown was twenty six point five percent patients were screen with histology.
149 person with serology and both claudettes and histology was used in 101. Percent of patients. Closest alone was used in three point two percent and urea breath test was very rarely used as we can see only 05.
Percent of patients had you do breath test used for this pie chart. We included any kind of test as was done either during the hospitalization or after the hospitalization as long as we had a follow up data.
So what we found was around half of the patients to be adequate to be accurate. Forty five percent of patients. Did not have any screening for h.
Pylori. In spite of having a documented peptic ulcer bleeding and we think these results are generalizable to other institutions. Even though.
This is a single institution study. Some studies on medicare data have shown that the compliance to h. Pylori.
Testing is varies from thirty percent to forty five percent in this population. Not only we found that we were little sub optimal with respect to screening. We also found the utilization of preferred test with high accuracy such as julia breath test was less than what is recommended in the maastricht.
Three guidelines. We also found the number of biopsies taken when a person is on ppi and having bleeding should be two or more than two. But most of our patients who got the biopsy done either had one biopsy or maximum two biopsies.
We also found people who were tested and who came positive and were treated did not have a retesting done. Neither did patient who had initial histology test done and came up negative. They were rescreened because there was concern of them being false negative.
So we think there should be future efforts to look at this problem especially in a prospective fashion. One of the key things that can this quality improvement initiative would be to find a developer strategy for post hospitalization. Urea.
Breath testing. It has been shown by this board. That posterior breath test is very accurate as far as you change post hospitalization from a ppi to h2 blocker.
So follow up of our study. Would be a prospective study. We will take a cohort of patients and try to have a quality improvement initiative to increase our compliance to h.
Pylori screening from around half to more than ninety percent and we are using these three quality indicators first every patient with peptic ulcer bleeding should be screened for one or more h. Pylori recommended test. And if they are tested positive and treated.
They should be retested for hp lurie to ensure they eradicated especially in population like ours. Which has a high resistance to standard h. Pylori treatment.
We also want to see that every person that comes positive for h. Pylori gets eradication. And sometimes during the hospital discharge process.
The test of the h. Valerie may come positive later on and no one may be able to capture the results. So we also tracking that is a quality indicator that anyone who gets positive edge mario test.
Even post discharge gets her dedication treatment well thats very much it for the poster. Thank you very much .
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