Outcomes of Upper Gastrointestinal Bleeding Based on Time to Endoscopy: A Retrospective Study
| Autor: | Divey Manocha, Sana Riaz, Sheikh A. Saleem, Pujitha Kudaravalli, Venkata Satish Pendela, Dhruv Lowe, Dongliang Wang |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Lower gastrointestinal bleeding Psychological intervention 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine upper gastrointestinal bleeding timing Medicine endoscopy interventions medicine.diagnostic_test business.industry Esophagogastroduodenoscopy Gastroenterology General Engineering Retrospective cohort study Bleed medicine.disease mortality Endoscopy Surgery Upper gastrointestinal bleeding business Packed red blood cells 030217 neurology & neurosurgery |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| DOI: | 10.7759/cureus.7325 |
| Popis: | Introduction Non-variceal upper gastrointestinal bleeding (UGIB) is a major burden on the health care system. The timing of endoscopy has been an ongoing debate and data on the association of early endoscopy with a better or worse clinical outcome are conflicting. In our study, we aimed to identify the benefits versus the risks of performing an urgent endoscopy in regards to the number of endoscopic interventions, length of hospital stay, number of packed red blood cells (PRBCs) transfused, and mortality. Methodology This is a retrospective record-based study. A total of 806 charts were reviewed and 251 patients with the signs and symptoms of UGIB on presentation were included in the study. Patients with variceal bleeding, lower gastrointestinal bleeding, insignificant bleeds with no drop in H/H, GI bleed not being the presenting complaint on admission, and patients on anticoagulation were excluded. Results Out of the patients who underwent an urgent esophagogastroduodenoscopy (EGD), 26.2% needed a second-look EGD 48 hours after the first EGD when compared to 4% and 2% in the early (12-24 hours) and late (>24 hours) endoscopy groups, respectively. In patients who underwent urgent EGD, 23% had active bleeding and it was statistically significant when compared to the other groups. The active bleeding limited the visualization during the endoscopy, which led to a repeat EGD in the urgent EGD group. If an endoscopic intervention was received, patients having EGD >24 hours received a smaller number of interventions. There was no statistical difference in the Blatchford scores between the three groups, indicating that the groups were similar in morbidity. No difference in mortality, hospital length of stay, or number of blood transfusions received, surgical or interventional radiology-guided interventions was found between the three groups. Conclusion Patients who underwent urgent endoscopy had more procedures, with no difference in mortality, number of units of blood transfused, or length of hospitalization when compared to the early or late endoscopy groups. |
| Databáze: | OpenAIRE |
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