The Time of Endoscopy for Nonvariceal Upper Gastrointestinal Bleeding: An Observational Study
Objectives In cases of nonvariceal upper gastrointestinal bleeding (NVUGIB), endoscopic intervention within the first 24 hours is widely recommended. However, data on the efficacy of urgent endoscopy are limited. Here, we used the Glasgow–Blatchford score to assess bleeding outcomes based on time-to...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean College of Helicobacter and Upper Gastrointestinal Research
2024-09-01
|
| Series: | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
| Subjects: | |
| Online Access: | http://helicojournal.org/upload/pdf/kjhugr-2024-0028.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850057982965972992 |
|---|---|
| author | Seong Woo Jeon Joong Goo Kwon Ju Yup Lee Si Hyung Lee Ho Jin Lee Daegu-Gyeongbuk Gastrointestinal Study Group (DGSG) |
| author_facet | Seong Woo Jeon Joong Goo Kwon Ju Yup Lee Si Hyung Lee Ho Jin Lee Daegu-Gyeongbuk Gastrointestinal Study Group (DGSG) |
| author_sort | Seong Woo Jeon |
| collection | DOAJ |
| description | Objectives In cases of nonvariceal upper gastrointestinal bleeding (NVUGIB), endoscopic intervention within the first 24 hours is widely recommended. However, data on the efficacy of urgent endoscopy are limited. Here, we used the Glasgow–Blatchford score to assess bleeding outcomes based on time-to-endoscopy. Methods Prospectively collected multicenter data, which included 1554 patients with NVUGIB, were retrospectively reviewed between February 2011 and December 2013. Based on time-to-endoscopy, patients were grouped into the early (<24 hours) versus the delayed (≥24 hours) group and the urgent (<6 hours) versus the nonurgent (≥6 hours) group. The rates of re-bleeding, mortality, secondary intervention, transfusion, and morbidity aggravation were analyzed. Results The mean time-to-endoscopy and median Glasgow–Blatchford score were 33.0±75.5 hours and 12 (range: 1–23), respectively. Univariate analyses revealed that in the delayed endoscopy group, the transfusion and re-bleeding rates were higher (hazard ratio [HR]: 1.257, 95% confidence interval [CI]: 1.026–1.540) and lower (HR: 0.610, 95% CI: 0.413–0.901), respectively. Multivariate analysis revealed that delayed endoscopy was a significant factor for lower re-bleeding rate (HR: 0.576, 95% CI: 0.387– 0.859), which was prominent in the low-risk group (HR: 0.417, 95% CI: 0.225–0.774). Multivariate analysis showed that when compared with the low-risk group, in-hospital comorbidity aggravation was more common in high-risk patients who underwent non-urgent endoscopy (HR: 2.957, 95% CI: 1.045–6.454). Conclusions In low-risk patients, delayed endoscopy is sufficient for NVUGIB management. In high-risk patients, urgent endoscopy reduced comorbidity aggravation during hospital care. |
| format | Article |
| id | doaj-art-a97234d700564befa84546cc34f37bea |
| institution | DOAJ |
| issn | 1738-3331 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Korean College of Helicobacter and Upper Gastrointestinal Research |
| record_format | Article |
| series | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
| spelling | doaj-art-a97234d700564befa84546cc34f37bea2025-08-20T02:51:16ZengKorean College of Helicobacter and Upper Gastrointestinal ResearchThe Korean Journal of Helicobacter and Upper Gastrointestinal Research1738-33312024-09-0124326727510.7704/kjhugr.2024.0028858The Time of Endoscopy for Nonvariceal Upper Gastrointestinal Bleeding: An Observational StudySeong Woo Jeon0Joong Goo Kwon1Ju Yup Lee2Si Hyung Lee3Ho Jin Lee4Daegu-Gyeongbuk Gastrointestinal Study Group (DGSG) Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea Department of Nursing, Yeungnam University College, Daegu, KoreaObjectives In cases of nonvariceal upper gastrointestinal bleeding (NVUGIB), endoscopic intervention within the first 24 hours is widely recommended. However, data on the efficacy of urgent endoscopy are limited. Here, we used the Glasgow–Blatchford score to assess bleeding outcomes based on time-to-endoscopy. Methods Prospectively collected multicenter data, which included 1554 patients with NVUGIB, were retrospectively reviewed between February 2011 and December 2013. Based on time-to-endoscopy, patients were grouped into the early (<24 hours) versus the delayed (≥24 hours) group and the urgent (<6 hours) versus the nonurgent (≥6 hours) group. The rates of re-bleeding, mortality, secondary intervention, transfusion, and morbidity aggravation were analyzed. Results The mean time-to-endoscopy and median Glasgow–Blatchford score were 33.0±75.5 hours and 12 (range: 1–23), respectively. Univariate analyses revealed that in the delayed endoscopy group, the transfusion and re-bleeding rates were higher (hazard ratio [HR]: 1.257, 95% confidence interval [CI]: 1.026–1.540) and lower (HR: 0.610, 95% CI: 0.413–0.901), respectively. Multivariate analysis revealed that delayed endoscopy was a significant factor for lower re-bleeding rate (HR: 0.576, 95% CI: 0.387– 0.859), which was prominent in the low-risk group (HR: 0.417, 95% CI: 0.225–0.774). Multivariate analysis showed that when compared with the low-risk group, in-hospital comorbidity aggravation was more common in high-risk patients who underwent non-urgent endoscopy (HR: 2.957, 95% CI: 1.045–6.454). Conclusions In low-risk patients, delayed endoscopy is sufficient for NVUGIB management. In high-risk patients, urgent endoscopy reduced comorbidity aggravation during hospital care.http://helicojournal.org/upload/pdf/kjhugr-2024-0028.pdfbleedingendoscopymortalitymorbidity |
| spellingShingle | Seong Woo Jeon Joong Goo Kwon Ju Yup Lee Si Hyung Lee Ho Jin Lee Daegu-Gyeongbuk Gastrointestinal Study Group (DGSG) The Time of Endoscopy for Nonvariceal Upper Gastrointestinal Bleeding: An Observational Study The Korean Journal of Helicobacter and Upper Gastrointestinal Research bleeding endoscopy mortality morbidity |
| title | The Time of Endoscopy for Nonvariceal Upper Gastrointestinal Bleeding: An Observational Study |
| title_full | The Time of Endoscopy for Nonvariceal Upper Gastrointestinal Bleeding: An Observational Study |
| title_fullStr | The Time of Endoscopy for Nonvariceal Upper Gastrointestinal Bleeding: An Observational Study |
| title_full_unstemmed | The Time of Endoscopy for Nonvariceal Upper Gastrointestinal Bleeding: An Observational Study |
| title_short | The Time of Endoscopy for Nonvariceal Upper Gastrointestinal Bleeding: An Observational Study |
| title_sort | time of endoscopy for nonvariceal upper gastrointestinal bleeding an observational study |
| topic | bleeding endoscopy mortality morbidity |
| url | http://helicojournal.org/upload/pdf/kjhugr-2024-0028.pdf |
| work_keys_str_mv | AT seongwoojeon thetimeofendoscopyfornonvaricealuppergastrointestinalbleedinganobservationalstudy AT joonggookwon thetimeofendoscopyfornonvaricealuppergastrointestinalbleedinganobservationalstudy AT juyuplee thetimeofendoscopyfornonvaricealuppergastrointestinalbleedinganobservationalstudy AT sihyunglee thetimeofendoscopyfornonvaricealuppergastrointestinalbleedinganobservationalstudy AT hojinlee thetimeofendoscopyfornonvaricealuppergastrointestinalbleedinganobservationalstudy AT daegugyeongbukgastrointestinalstudygroupdgsg thetimeofendoscopyfornonvaricealuppergastrointestinalbleedinganobservationalstudy AT seongwoojeon timeofendoscopyfornonvaricealuppergastrointestinalbleedinganobservationalstudy AT joonggookwon timeofendoscopyfornonvaricealuppergastrointestinalbleedinganobservationalstudy AT juyuplee timeofendoscopyfornonvaricealuppergastrointestinalbleedinganobservationalstudy AT sihyunglee timeofendoscopyfornonvaricealuppergastrointestinalbleedinganobservationalstudy AT hojinlee timeofendoscopyfornonvaricealuppergastrointestinalbleedinganobservationalstudy AT daegugyeongbukgastrointestinalstudygroupdgsg timeofendoscopyfornonvaricealuppergastrointestinalbleedinganobservationalstudy |