Clinical outcome of acute nonvariceal upper gastrointestinal bleeding after hours: the role of urgent endoscopy
The Korean Journal of Internal Medicine
;
: 470-478, 2016.
Article
in English
| WPRIM
| ID: wpr-101300
ABSTRACT
BACKGROUND/AIMS:
This study was performed to investigate the clinical role of urgent esophagogastroduodenoscopy (EGD) for acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) performed by experienced endoscopists after hours.METHODS:
A retrospective analysis was performed for consecutively collected data of patients with ANVUGIB between January 2009 and December 2010.RESULTS:
A total of 158 patients visited the emergency unit for ANVUGIB after hours. Among them, 60 underwent urgent EGD (within 8 hours) and 98 underwent early EGD (8 to 24 hours) by experienced endoscopists. The frequencies of hemodynamic instability, fresh blood aspirate on the nasogastric tube, and high-risk endoscopic findings were significantly higher in the urgent EGD group. Primary hemostasis was achieved in all except two patients. There were nine cases of recurrent bleeding, and 30-day mortality occurred in three patients. There were no significant differences between the two groups in primary hemostasis, recurrent bleeding, and 30-day mortality. In a multiple linear regression analysis, urgent EGD significantly reduced the hospital stay compared with early EGD. In patients with a high clinical Rockall score (more than 3), urgent EGD tended to decrease the hospital stay, although this was not statistically significant (7.7 days vs. 12.0 days, p > 0.05).CONCLUSIONS:
Urgent EGD after hours by experienced endoscopists had an excellent endoscopic success rate. However, clinical outcomes were not significantly different between the urgent and early EGD groups.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Linear Models
/
Retrospective Studies
/
Mortality
/
Endoscopy, Digestive System
/
Hemostasis, Endoscopic
/
Emergency Service, Hospital
/
Endoscopy
/
Hemodynamics
/
Hemorrhage
/
Hemostasis
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
The Korean Journal of Internal Medicine
Year:
2016
Type:
Article
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