Safety and Efficacy of Sedation During Emergency Endoscopy for Upper Gastrointestinal Bleeding: A Propensity Score Matching Analysis

Autor: Daisuke Yamaguchi, Goshi Nagatsuma, Yasuhisa Sakata, Yumi Mizuta, Tadahiro Nomura, Azuki Jinnouchi, Kasumi Gondo, Ryosuke Asahi, Satoshi Ishida, Shunichiro Kimura, Shun Fujimoto, Akane Shimakura, Amane Jubashi, Yuki Takeuchi, Kei Ikeda, Yuichiro Tanaka, Wataru Yoshioka, Naoyuki Hino, Tomohito Morisaki, Keisuke Ario, Seiji Tsunada, Motohiro Esaki
Rok vydání: 2022
Předmět:
Zdroj: Digestive Diseases and Sciences. 68:1426-1434
ISSN: 1573-2568
0163-2116
DOI: 10.1007/s10620-022-07740-0
Popis: This study aimed to compare patients with and without sedation during emergency endoscopy for upper gastrointestinal bleeding (UGIB) and to clarify the safety and efficacy of sedation in emergency endoscopy.We retrospectively collected 389 patients who underwent emergency endoscopy for UGIB at Ureshino Medical Center from 2016 to 2021. Patients were divided into two groups: sedation group during emergency endoscopy and nonsedation group. Clinical characteristics, patient status on admission, and UGIB etiology were evaluated. Treatment outcomes and adverse events were evaluated using propensity score matching (PSM), and risk factors for mortality from UGIB were investigated using Cox multivariate analysis.The sedation group was significantly younger, composed of a higher proportion of males, and had chronic liver disease. Blood pressure and hemoglobin level on admission were significantly higher in the sedation group. The main cause of bleeding was peptic ulcer, which was significantly higher in the nonsedation group. PSM created 133 matched pairs. The success rate of endoscopic hemostasis was similar in both groups, and procedure time was significantly shorter in the sedation group than in the nonsedation group (17.6 ± 10.0 versus 20.2 ± 10.2 min, P = 0.04). There were no significant differences in adverse events between groups. Cox multivariate analyses revealed that red blood cell transfusion [hazard ratio (HR) 4.45, P 0.02] and rebleeding (HR 3.30, P = 0.03) were associated with increased risk of 30-day mortality from UGIB.Sedation reduced the procedure time during emergency endoscopy for UGIB. Sedation during emergency endoscopy for UGIB is acceptable for safe endoscopic procedures.
Databáze: OpenAIRE
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