Upper Gastrointestinal Bleeding: Do Emergency Endoscopic Evaluations Affect Clinical Outcomes?

Authors : Osman İNAN, Muhammed Fatih ACEHAN, Buket KARSAVURANOĞLU, Enes Seyda ŞAHİNER, Meryem ASLAN, İhsan ATEŞ

Pages : 440-449

Doi:10.19127/mbsjohs.1130292

View : 25 | Download : 9

Publication Date : 2022-08-31

Article Type : Research Paper

Abstract :Objective: We aimed to reveal the effect of time from admission to endoscopy on clinical outcomes such as mortality, rebleeding, and prolonged hospitalization among patients with acute upper gastrointestinal bleeding. Methods: Patients aged ≥18 years with acute upper gastrointestinal bleeding were enrolled in the study. Those who had variceal bleeding during endoscopy, those whose hospital stay was shorter than 24 hours, those who did not undergo endoscopy, and those who underwent endoscopy after 24 hours were excluded from the study. Clinical findings, routine laboratory test results, and imaging findings of the patients were retrospectively reviewed through the hospital’s records system. Results: A total of 252 patients were enrolled in the study. At admission, 30.2% insert ignore into journalissuearticles values(76); of patients were at clinically high risk of death or rebleeding, 71.8% had melena, and 51.2% had hematemesis. While 72 insert ignore into journalissuearticles values(28.6%); of the patients had high-risk endoscopic stigmata, 89 insert ignore into journalissuearticles values(35.3%); had low-risk endoscopic stigmata. The median hospital stay was 6 insert ignore into journalissuearticles values(1-91); days. In-hospital mortality occurred in 8 insert ignore into journalissuearticles values(3.2%); cases, rebleeding developed in 16 insert ignore into journalissuearticles values(6.3%); cases, endoscopic intervention was required in 103 insert ignore into journalissuearticles values(40.9%); cases, and prolonged hospital stay was required in 43 insert ignore into journalissuearticles values(17.1%); cases. High-risk endoscopic stigmata were identified in 63 insert ignore into journalissuearticles values(34.1%); cases in the urgent group and in 9 insert ignore into journalissuearticles values(13.4%); in the early group insert ignore into journalissuearticles values(p=0.001);. Endoscopic intervention was required in 47.0% cases in the urgent group, while the incidence was 23.9% in the early group insert ignore into journalissuearticles values(p=0.001);. Conclusion: While no significant difference was found between the urgent and early groups in terms of mortality and re-bleeding, the need for endoscopic intervention and the incidence of high-risk endoscopic stigmata were found to be significantly higher in the urgent group.
Keywords : Endoscopy, Outcome, Upper gastrointestinal bleeding