BACKGROUND/AIMS: Gastrointestinal endoscopy is imperative for acute upper gastrointestinal bleeding (AUGIB) to find bleeding focus and stop bleeding. This study was designed to assess the necessity of emergency endoscopy and determine screening criteria for the patients who presented to emergency room (ER) with after-hours AUGIB. METHODS: The medical records of 383 patents with AUGIB who presented to ER at after-hours were reviewed. Patients were divided into 2 groups: emergency endoscopy (EE) group (<12 hours after arrival) or delayed endoscopy (DE) group (12-24 hours after arrival). We compared the severity, hemostatic procedures, rebleeding rate, length of hospitalization and 30-day mortality between the two groups. RESULTS: Ninety-eight patients in EE group and 137 patients in DE group were evaluated among patients with non-variceal upper gastrointestinal bleeding. No significant differences in clinical severity, finding the bleeding focus, hemostasis, 30-day mortality, hospital stay, and rebleeding rate were observed between the two groups. Among 148 patients with variceal upper gastrointestinal bleeding, 65 patients were in EE group and 83 patients in DE group. Most clinical severity index were not different between the groups. In EE group, the rate of finding bleeding foci was lower (p=0.043), and 30-day mortality was higher than in DE group (p=0.023). CONCLUSIONS: Emergency endoscopy within 12 hours after arrival at after-hours do not lead to better prognosis in AUGIB.
BACKGROUND/AIMS: Gastrointestinal endoscopy is imperative for acute upper gastrointestinal bleeding (AUGIB) to find bleeding focus and stop bleeding. This study was designed to assess the necessity of emergency endoscopy and determine screening criteria for the patients who presented to emergency room (ER) with after-hours AUGIB. METHODS: The medical records of 383 patents with AUGIB who presented to ER at after-hours were reviewed. Patients were divided into 2 groups: emergency endoscopy (EE) group (<12 hours after arrival) or delayed endoscopy (DE) group (12-24 hours after arrival). We compared the severity, hemostatic procedures, rebleeding rate, length of hospitalization and 30-day mortality between the two groups. RESULTS: Ninety-eight patients in EE group and 137 patients in DE group were evaluated among patients with non-variceal upper gastrointestinal bleeding. No significant differences in clinical severity, finding the bleeding focus, hemostasis, 30-day mortality, hospital stay, and rebleeding rate were observed between the two groups. Among 148 patients with variceal upper gastrointestinal bleeding, 65 patients were in EE group and 83 patients in DE group. Most clinical severity index were not different between the groups. In EE group, the rate of finding bleeding foci was lower (p=0.043), and 30-day mortality was higher than in DE group (p=0.023). CONCLUSIONS: Emergency endoscopy within 12 hours after arrival at after-hours do not lead to better prognosis in AUGIB.
Authors: Dong-Won Ahn; Young Soo Park; Sang Hyub Lee; Cheol Min Shin; Jin-Hyeok Hwang; Jin-Wook Kim; Sook-Hyang Jeong; Nayoung Kim; Dong Ho Lee Journal: Korean J Intern Med Date: 2016-04-06 Impact factor: 2.884