Impact of a novel protocol for atrial fibrillation management in outpatient gastrointestinal endoscopic procedures: a retrospective cohort study
Abstract Background Atrial fibrillation (AF) may result in procedure cancellations and emergency department (ED) referrals for patients presenting for outpatient GI endoscopic procedures. Such cancellations and referrals delay patient care and can lead to inefficient use of resources. Methods All co...
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| Format: | Article |
| Language: | English |
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BMC
2018-09-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12872-018-0915-0 |
| _version_ | 1819162258452774912 |
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| author | Joseph Longino Ashish Chaddha Matthew M. Kalscheur Anne M. Rikkers Deepak V. Gopal Michael E. Field Jennifer M. Wright |
| author_facet | Joseph Longino Ashish Chaddha Matthew M. Kalscheur Anne M. Rikkers Deepak V. Gopal Michael E. Field Jennifer M. Wright |
| author_sort | Joseph Longino |
| collection | DOAJ |
| description | Abstract Background Atrial fibrillation (AF) may result in procedure cancellations and emergency department (ED) referrals for patients presenting for outpatient GI endoscopic procedures. Such cancellations and referrals delay patient care and can lead to inefficient use of resources. Methods All consecutive patients presenting in AF for a colonoscopy or upper endoscopy to the University of Wisconsin Digestive Health Center between October 2013 and September 2014 were defined as the pre-intervention group (Group 1). In 2015, a protocol was initiated for peri-procedural management of patients presenting in AF, new onset or previously known. All consecutive patients after initiation of the protocol from October 2015 to September 2016 were analyzed as the post intervention group (Group 2). Patients with heart failure, hypotension, or chest pain were excluded from the protocol. Results One hundred nine and 141 patients were included in Groups 1 and Group 2, respectively. Following protocol initiation, patients were less likely to present to the ED (6.4% Group 1 vs. 1.4% Group 2, RR 0.22, p = 0.04). There was also a trend towards a reduction in procedure cancelations (5.5% Group 1 vs. 1.4% Group 2, RR 0.26, p = 0.08). All attempted procedures were completed and there were no complications in the intervention group. Conclusions Implementation of a standardized protocol for management of atrial fibrillation in patients presenting for outpatient gastrointestinal endoscopic procedures resulted in a significant decrease in emergency department visits with an additional trend toward decreased procedural cancellations without an increased risk of complications. |
| first_indexed | 2024-12-22T17:25:23Z |
| format | Article |
| id | doaj.art-a1e57314565d4c578b502f246cca5142 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-22T17:25:23Z |
| publishDate | 2018-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-a1e57314565d4c578b502f246cca51422022-12-21T18:18:44ZengBMCBMC Cardiovascular Disorders1471-22612018-09-011811510.1186/s12872-018-0915-0Impact of a novel protocol for atrial fibrillation management in outpatient gastrointestinal endoscopic procedures: a retrospective cohort studyJoseph Longino0Ashish Chaddha1Matthew M. Kalscheur2Anne M. Rikkers3Deepak V. Gopal4Michael E. Field5Jennifer M. Wright6Department of Medicine, Division of Cardiology, University of Wisconsin School of Medicine and Public HealthDepartment of Cardiology, Beaumont HospitalDepartment of Medicine, Division of Cardiology, University of Wisconsin School of Medicine and Public HealthDepartment of Emergency Services, University of Wisconsin School of Medicine and Public HealthDepartment of Medicine, Division of Gastroenterology & Hepatology, University of Wisconsin School of Medicine and Public HealthDepartment of Medicine, Division of Cardiology, Medical University of South Carolina and Ralph H. Johnson Veterans Administration Medical CenterDepartment of Medicine, Division of Cardiology, University of Wisconsin School of Medicine and Public HealthAbstract Background Atrial fibrillation (AF) may result in procedure cancellations and emergency department (ED) referrals for patients presenting for outpatient GI endoscopic procedures. Such cancellations and referrals delay patient care and can lead to inefficient use of resources. Methods All consecutive patients presenting in AF for a colonoscopy or upper endoscopy to the University of Wisconsin Digestive Health Center between October 2013 and September 2014 were defined as the pre-intervention group (Group 1). In 2015, a protocol was initiated for peri-procedural management of patients presenting in AF, new onset or previously known. All consecutive patients after initiation of the protocol from October 2015 to September 2016 were analyzed as the post intervention group (Group 2). Patients with heart failure, hypotension, or chest pain were excluded from the protocol. Results One hundred nine and 141 patients were included in Groups 1 and Group 2, respectively. Following protocol initiation, patients were less likely to present to the ED (6.4% Group 1 vs. 1.4% Group 2, RR 0.22, p = 0.04). There was also a trend towards a reduction in procedure cancelations (5.5% Group 1 vs. 1.4% Group 2, RR 0.26, p = 0.08). All attempted procedures were completed and there were no complications in the intervention group. Conclusions Implementation of a standardized protocol for management of atrial fibrillation in patients presenting for outpatient gastrointestinal endoscopic procedures resulted in a significant decrease in emergency department visits with an additional trend toward decreased procedural cancellations without an increased risk of complications.http://link.springer.com/article/10.1186/s12872-018-0915-0Atrial fibrillationEndoscopyEmergency medicine |
| spellingShingle | Joseph Longino Ashish Chaddha Matthew M. Kalscheur Anne M. Rikkers Deepak V. Gopal Michael E. Field Jennifer M. Wright Impact of a novel protocol for atrial fibrillation management in outpatient gastrointestinal endoscopic procedures: a retrospective cohort study BMC Cardiovascular Disorders Atrial fibrillation Endoscopy Emergency medicine |
| title | Impact of a novel protocol for atrial fibrillation management in outpatient gastrointestinal endoscopic procedures: a retrospective cohort study |
| title_full | Impact of a novel protocol for atrial fibrillation management in outpatient gastrointestinal endoscopic procedures: a retrospective cohort study |
| title_fullStr | Impact of a novel protocol for atrial fibrillation management in outpatient gastrointestinal endoscopic procedures: a retrospective cohort study |
| title_full_unstemmed | Impact of a novel protocol for atrial fibrillation management in outpatient gastrointestinal endoscopic procedures: a retrospective cohort study |
| title_short | Impact of a novel protocol for atrial fibrillation management in outpatient gastrointestinal endoscopic procedures: a retrospective cohort study |
| title_sort | impact of a novel protocol for atrial fibrillation management in outpatient gastrointestinal endoscopic procedures a retrospective cohort study |
| topic | Atrial fibrillation Endoscopy Emergency medicine |
| url | http://link.springer.com/article/10.1186/s12872-018-0915-0 |
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