Objective Lower GI bleeding (LGIB) is a common reason for emergency hospital admission, although there is paucity of data on presentations, interventions and outcomes. In this nationwide UK audit, we describe patient characteristics, interventions including endoscopy, radiology and surgery as well as clinical outcomes. Design Multicentre audit of adults presenting with LGIB to UK hospitals over 2 months in 2015. Consecutive cases were prospectively enrolled by clinical teams and followed for 28 days. Results Data on 2528 cases of LGIB were provided by 143 hospitals. Most were elderly (median age 74 years) with major comorbidities, 29.4% taking antiplatelets and 15.9% anticoagulants. Shock was uncommon (58/2528, 2.3%), but 666 (26.3%) received a red cell transfusion. Flexible sigmoidoscopy was the most common investigation (21.5%) but only 2.1% received endoscopic haemostasis. Use of embolisation or surgery was rare, used in 19 (0.8%) and 6 (0.2%) cases, respectively. 48% patients underwent no inpatient investigations. The most common diagnoses were diverticular bleeding (26.4%) and benign anorectal conditions (16.7%). Median length of stay was 3 days, 13.6% patients rebled during admission and 4.4% were readmitted with bleeding within 28 days. In-hospital mortality was 85/2528 (3.4%) and was highest in established inpatients (17.8%, p<0.0001) and in patients experiencing rebleeding (7.1%, p<0.0001). Conclusions Patients with LGIB have a high burden of comorbidity and frequent antiplatelet or anticoagulant use. Red cell transfusion was common but most patients were not shocked and required no endoscopic, radiological or surgical treatment. Nearly half were not investigated. In-hospital mortality was related to comorbidity, not severe haemorrhage.

中文翻译：

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英国急性下消化道出血：首次全国审计中的患者特征、干预措施和结果

目的 下消化道出血 (LGIB) 是急诊入院的常见原因，尽管缺乏有关表现、干预和结果的数据。在这项全国性的英国审核中，我们描述了患者特征、包括内窥镜检查、放射学和手术在内的干预措施以及临床结果。设计对 2015 年 2 个月内在英国医院就诊的 LGIB 成人进行的多中心审核。临床团队前瞻性地招募了连续病例，并进行了 28 天的随访。结果 143家医院共提供2528例LGIB数据。大多数是老年人（中位年龄 74 岁）有严重的合并症，29.4% 服用抗血小板药物，15.9% 服用抗凝剂。休克不常见 (58/2528, 2.3%)，但 666 (26.3%) 接受了红细胞输注。软性乙状结肠镜检查是最常见的检查 (21.5%)，但只有 2 个。1% 接受了内窥镜止血。栓塞或手术的使用很少见，分别用于 19 (0.8%) 和 6 (0.2%) 例。48% 的患者未接受住院检查。最常见的诊断是憩室出血 (26.4%) 和良性肛门直肠疾病 (16.7%)。中位住院时间为 3 天，13.6% 的患者在入院期间再次出血，4.4% 的患者在 28 天内因出血再次入院。院内死亡率为 85/2528 (3.4%)，在住院患者中最高 (17.8%, p<0.0001) 和再出血患者 (7.1%, p<0.0001)。结论 LGIB 患者的合并症负担高，经常使用抗血小板或抗凝剂。红细胞输血很常见，但大多数患者没有电击，也不需要内窥镜、放射或手术治疗。将近一半没有被调查。