TP6.2.17 How good is Edinburgh Dysphagia Score in identifying patients with oesophageal cancer?

Aims Due to limited resources and increase in the referral for endoscopy, various scoring systems have been developed in an attempt to identify high risk patients of having oesophageal cancer. The aim of this study was to analyze the utility of Edinburgh Dysphagia Score (EDS) in patients who have presented with oesophageal cancer. Methods A retrospective cohort study of all newly diagnosed oesophageal cancers with dysphagia in a single regional MDT was performed between October 2019 and September 2020. Electronic records were interrogated and EDS calculated. EDS contained six parameters: age, sex, weight loss, duration of symptoms, localization of dysphagia and acid reflux. Patients divided into lower-risk group (EDS <3.5) and higher-risk group (EDS ≥ 3.5). Results Of the 349 patients, 182 (52.1%) had dysphagia at presentation. 149 (81.9%) were referred from the primary care. There were 127 (69.8%) male and the mean age was 69.1 ± 11.0 years. 135 (74.2%) patients had adenocarcinoma, 51 (28.0%) were T4 disease and 58 (31.9%) were metastatic. The median EDS was 7 (IQR 6-8). 178 (97.8%) patients had higher-risk EDS and 4 (2.2%) patients lower-risk EDS. Conclusions This study suggests that EDS can positively identify patients who are high risk of having oesophageal cancer in majority of patients. This simple scoring system can be used to vet the referrals in order to reduce the pressure in the secondary care setting to effectively use the available resources.

EP.TH.155Assessment of the appropriate use of imaging and reporting in acute pancreatitis in a secondary care setting

Background Acute pancreatitis is the world's most common gastrointestinal disease requiring hospital admission. Our audit aim was to assess the timeframe within which Abdominal Ultrasound Scans (USS) and Computerised Tomography (CT) were performed, reported indications for CT and the prognostic factors noted in imaging reports. Methodology A retrospective search included admissions with acute pancreatitis between 01/09/19 to 30/11/19, collecting demographics, admission time & date, time and date of both radiological investigations and imaging reports. Patients under the age of 18 were excluded. Results This search identified 75 patients (M:F, 40:35) with a median age of 53 (18-95) years. USS were performed within 24 hours of admission in 40.0% (n = 30) of cases. Out of the patients (n = 44) who received a CT scan, 15.9% (n = 7) were scanned after more than 72 hours of onset of symptoms and 84.1% (n = 37) were scanned within less than 72 hours. Furthermore, 88.6%(n = 39) of CT request indications were in keeping with our standards. The average length of hospital stay was 6.1 days when scanned within 72 hours and 11.8 days when scanned after more than 72 hours. Conclusion Only 17.3% (n = 13) of the patients audited met all our standards and were managed according to the guidelines. The average length of hospital stay was half in those who had a CT scan after more than 72 hours of admission and this was also used to monitor disease progression/regression.

1323 Assessment of The Appropriate Use of Imaging and Reporting in Acute Pancreatitis in A Secondary Care Setting

Aim Acute pancreatitis is the world's most common gastrointestinal disease requiring hospital admission. Our audit aim was to assess the timeframe within which Abdominal Ultrasound Scans (USS) and Computerised Tomography (CT) were performed, reported indications for CT and the prognostic factors noted in imaging reports. Method A retrospective search included admissions with acute pancreatitis between 01/09/19 to 30/11/19, collecting demographics, admission time & date, time and date of both radiological investigations and imaging reports. Patients under the age of 18 were excluded. Results This search identified 75 patients (M:F, 40:35) with a median age of 53 (18-95) years. USS were performed within 24 hours of admission in 40.0% (n = 30) of cases. Out of the patients (n = 44) who received a CT scan, 15.9% (n = 7) were scanned after more than 72 hours of onset of symptoms and 84.1% (n = 37) were scanned within less than 72 hours. Furthermore, 88.6%(n = 39) of CT request indications were in keeping with our standards. The average length of hospital stay was 6.1 days when scanned within 72 hours and 11.8 days when scanned after more than 72 hours. Conclusions Only 17.3% (n = 13) of the patients audited met all our standards and were managed according to the guidelines. The average length of hospital stay was half in those who had a CT scan after more than 72 hours of admission and this was also used to monitor disease progression/regression.

A Longitudinal Assessment of the Quality of Insulin Prescribing with Different Prescribing Systems

Accurate and complete prescriptions of insulin are crucial to prevent medication errors from occurring. Two core components for safe insulin prescriptions are the word ‘units’ being written in full for the dose, and clear documentation of the insulin device alongside the name. A retrospective review of annual audit data was conducted for insulin prescriptions to assess the impact of changes to the prescribing system within a secondary care setting, at five time points over a period of 7 years (2014 to 2020). The review points were based on when changes were made, from standardized paper charts with a dedicated section for insulin prescribing, to a standalone hospital wide electronic prescribing and medicines administration (ePMA) system, and finally an integrated electronic health record system (EHRS). The measured outcomes were compliance with recommended standards for documentation of ‘units’ in full, and inclusion of the insulin device as part of the prescription. Overall, an improvement was seen in both outcomes of interest. Device documentation improved incrementally with each system change—34% for paper charts, 23%–56% for standalone ePMA, and 100% for ePMA integrated within EHRS. Findings highlight that differences in ePMA systems may have varying impact on safe prescribing practices.