P0611 - The Effect of Digital Rectal Exams in Patients Admitted with Acute Gastrointestinal Bleeding on Inpatient Hospitalization Outcomes

Yassmin Hegazy, MD¹, Parth Patel, MD¹, Nicholas Forrister, MD², Oreoluwa Adekunle, MD¹, Ahmed Saleh, MD¹, Christopher Price, MD¹, Ethan D. Pollack, MS, MD³, Mark Beasley, PhD¹, Mohamed Shoreibah, MD^1
1University of Alabama at Birmingham, Birmingham, AL; ²University of Alabama at Birmingham, Hoover, AL; ³University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL

Introduction: Digital Rectal Exams (DRE) are a vital assessment of patients presenting with acute gastrointestinal (GI) bleeding with some studies reporting underutilization of DRE in GI bleeding evaluation. Our study evaluates the effect of DRE on outcomes including timing of GI consultation, GI procedures, and days of hospitalization.

Methods: We performed a retrospective study of patients admitted with acute GI bleeding at our institution between January 2021 to July 2022. Data collected included baseline demographics, co-morbidities, anticoagulation and antiplatelet use, timing of GI consults, and type of GI procedure. Other outcomes included days of hospitalization and days in the intensive care unit (ICU). Univariate and multivariate regression analysis were used for statistical interpretation.

Results: Our cohort (N=172) had a median age of 60.5 ± 14.9, 60.7% were white, 60.1% male, 71.6% with a history of alcohol use, 24.3% with cirrhosis, 31.3% with current antiplatelet use, 20.3% with current anticoagulation use, and 61.6% on a proton pump inhibitor (PPI). Patients with DRE performed (N=86) differed from patients with DRE not performed on admission (N=86) in the number of GI consults requested (73.3% vs 56.3%), colonoscopies performed (61.0% vs 33.7%), and Esophagogastroduodenoscopy (EGD) performed (37.8% vs 63.9%). Days of hospitalization were 9.3 vs 14.7 (p-value 0.04) and days in the ICU were 5.8 vs 7.0 (p-value 0.52) in patients with DRE performed vs patients without DRE performed respectively (Table 1).

Discussion: In patients who had a DRE performed on admission, GI was more frequently consulted on admission and patients had decreased days of hospitalization during their admission compared to patients without DRE performed on admission. Our study indicates that DRE is a vital tool of initial assessment in patients with GI bleeding that can impact management, timing of GI consultation, and reduce inpatient hospitalization. More data is needed to assess further benefits of DRE inclusion in physical examination in patients admitted with acute GI bleeding and outcomes in this patient population.



Disclosures:


Yassmin Hegazy, MD¹, Parth Patel, MD¹, Nicholas Forrister, MD², Oreoluwa Adekunle, MD¹, Ahmed Saleh, MD¹, Christopher Price, MD¹, Ethan D. Pollack, MS, MD³, Mark Beasley, PhD¹, Mohamed Shoreibah, MD¹. P0611 - The Effect of Digital Rectal Exams in Patients Admitted with Acute Gastrointestinal Bleeding on Inpatient Hospitalization Outcomes, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.