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• W2914541661 abstract "Introduction: Initial management of acute upper gastrointestinal bleeding (UGIB) aims towards aggressive fluid resuscitation to maintain hemodynamic stability. Existing evidence regarding benefit of early endoscopy is unclear with some studies suggesting mortality benefits and some suggesting otherwise. The purpose of this study is to evaluate if there is any mortality benefit of doing early endoscopy within 24 hours of presentation.Table: Table. Results of Univariate Tests between Patients who had endoscopy within 24 hours compare to patients who had after 24 hoursMethods: From July 2013 to July 2016, 179 patients admitted with a diagnosis of non-variceal UGIB were retrospectively reviewed. Clinical variables including 30-day mortality were then compared between the patients who had endoscopy within 24 hours with those who had endoscopy after greater than 24 hours. Results: Out of 179 patients admitted for non-variceal UGIB, 146 underwent endoscopy within 24 hours and 3 underwent it after 24 hours of presentation. The overall mortality associated with UGIB was 6.6% (12/179). There was no statistically significant difference found in 30-day mortality among the two groups (6.8% within 24 hours vs 6.1% after 24 hours). There was also no difference in 30-day readmission (20.5% within 24 hours and 27.3% after 24 hours) and rates of rebleeding among the two groups (8.3% within 24 hours vs 12.1% after 24 hours). The length of stay was also similar in both groups (6 days vs 6.1 days). Conclusion: Upper GI bleeding is a common reason for hospital admission in United States. American college of Gastroenterology guidelines recommend endoscopy within 24 hours of presentation for UGIB. Studies showed decreased complications, length of stay and mortality with early endoscopy, though some studies showed poor outcomes with urgent endoscopy and increased utilization of medical resources. This study did not find any advantage of early endoscopy within 24 hours on length of stay, rate of complications and 30-day mortality. As hemostasis is achieved in almost 90% of patients with supportive management without any endoscopic intervention, focus should be made on aggressive fluid resuscitation as it has a clear mortality benefit." @default.
• W2914541661 created "2019-02-21" @default.
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• W2914541661 date "2017-10-01" @default.
• W2914541661 modified "2023-09-27" @default.
• W2914541661 title "Does Early Endoscopy Improve Mortality in Patients With Acute Non-variceal GI Bleed?" @default.
• W2914541661 doi "https://doi.org/10.14309/00000434-201710001-02713" @default.
• W2914541661 hasPublicationYear "2017" @default.
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