Impact of inter‐hospital transfer on success of angioembolization for lower gastrointestinal bleeding

Background Angioembolization is a useful therapeutic tool for lower gastrointestinal bleeding (LGIB) however is only available at centres with specialist interventional radiology departments. Delay in angioembolization of greater than 120–150 minutes is associated with higher rates of non‐therapeutic angioembolization. Methods This retrospective review analysed the impact of interhospital transfer on timing and success of angioembolization in adults with LGIB. Results Of the 121 patients who underwent CTMA at a peripheral hospital for LGIB, only 20.7% had positive CTMA (n = 25). Of the 24 patients who were transferred for the purpose of angioembolization, only five ultimately had successful embolisation (20.1%). Patients who had unsuccessful angioembolization had a significantly longer mean time from arrival at the tertiary hospital to angioembolization compared to patients who had successful angioembolization (mean 375 versus 175 min, P = 0.001). There was no association of patient haemodynamics, use of anticoagulant or antiplatelet therapy, and transfusion requirement with success of angioembolization. Conclusion Interhospital transfer is associated with delay in angioembolization. Delay after arrival at the receiving hospital is associated with unsuccessful angioembolization. Lower gastrointestinal bleeding can be effectively managed by angioembolization when performed timely. However not every hospital has the interventional radiology facilities to accommodate angioembolization necessitating transfer of these patients. We present a retrospective review analysing the impact of interhospital transfer on timing and success of angioembolization.