{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:43:36Z","timestamp":1783730616598,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,7,11]],"date-time":"2013-07-11T00:00:00Z","timestamp":1373500800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute severe colitis (<jats:styled-content style=\"fixed-case\">ASC<\/jats:styled-content>) is a serious condition with possible outcomes of emergency colectomy and mortality. Validated guidelines exist to help avoid these.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To examine local adherence to guidelines and identify (a) opportunities to improve care and (b) possible barriers to adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective, hospital\u2010wide audit of all patients with <jats:styled-content style=\"fixed-case\">ASC<\/jats:styled-content> during a 2\u2010year period (2009\u20132010) at a major metropolitan hospital. Cases were identified by an electronic search of all discharges with International Classification of Diseases\u201010 codes for colitis, colectomy, ulcerative colitis or <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>rohn disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010six patients had 30 <jats:styled-content style=\"fixed-case\">ASC<\/jats:styled-content> admissions (14 female). Most admissions were under gastroenterology (25), 4 (13%) were under general medicine and 1 was under general surgery. Only 8 patients' (26%) management (all under gastroenterology) included all major details: blood investigations, <jats:italic><jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>lostridium difficile<\/jats:italic> test, abdominal <jats:styled-content style=\"fixed-case\">X<\/jats:styled-content>\u2010ray, colonic examination and venous thromboembolism prophylaxis. Only one patient had formal severity scoring on admission, and seven patients (24%) had descriptive severity recorded. On day 3, nine patients (30%) had some recorded severity assessment; however, no formal criteria were used. Four had colectomy, three during first admission and one on re\u2010admission. Of these patients, three received cyclosporine prior to colectomy. The mean duration of admission was 10 days (standard deviation 10.54, range 1\u201361).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Opportunities to optimise care exist including formal severity assessments on days 1 and 3, better deep vein thrombosis\/pulmonary embolism prophylaxis and prompt colonic examination. Admission under teams other than gastroenterology appeared to be a barrier to better care. Despite the low rate of ideal management, the colectomy rate was acceptably low at 20%.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.12042","type":"journal-article","created":{"date-parts":[[2012,11,23]],"date-time":"2012-11-23T14:37:11Z","timestamp":1353681431000},"page":"803-809","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical audit: recent practice in caring for patients with acute severe colitis compared with published guidelines \u2013 is there a problem?"],"prefix":"10.1111","volume":"43","author":[{"given":"A. H.","family":"Lim","sequence":"first","affiliation":[{"name":"University of Adelaide"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Grafton","sequence":"additional","affiliation":[{"name":"Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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