PTH-169 Clinical Utility of a Rapid PCR Assay and Traditional CCNA to Detect Clostridium Difficile Infection (CDI) – Comparison to Clinical Diagnosis

Abstract

was collected retrospectively from patient case notes, endoscopy reporting system and emergency theatre records. Results 77 cases of AUGIB were identified with gender distribution of 56% males and 44% females. The median age of presentation was 67 years (range 20-93 years). Most cases of AUGIB (71%) were acute admissions with the rest occurring among in-patients.A major improvement in the service is that all patients had at least one endoscopy during their presentation with most endoscopies (67%) performed within 24 hours or less and a further (26%) carried out 2-7 days. Endoscopies were performed by gastroenterologist (66%), surgeons (20%) and specialist registrar (14%). About a third (27%) had out of hours (OOH) emergency endoscopies and the remaining procedures were carried out in the dedicated inpatient lists. Majority (62%) of the OOH procedures were done at the weekends.A notable shortcoming was poor risk assessment (18%) at presentation although retrospective risk scoring revealed a median Rockall Score of 3 (range 1-5). At presentation only 8% of patients were admitted to the dedicated gastroenterology ward before the first endoscopy while the majority (52%) were managed initially on the acute medical wards and discharged or subsequently admitted to the gastroenterology ward. Conclusion The introduction of a dedicated service has improved the management of AUGIB in our hospital serving a population of 325,000 particularly during the OOH. The findings of this retrospective audit showed an AUGIB service collaborating medical gastroenterologists and surgeons is workable and sustainable in the setting of a district general hospital.To further improve the service a dedicated AUGIB clerking proforma incorporating Rockall risk score assessment is being considered.