Objective:The role of urgent endoscopy in nonvariceal upper gastrointestinal hemorrhage(NVUGIH)remains controversial.We designed a retrospective study to compare the outcomes between urgent endoscopy(within 12 h)and non-urgent endoscopy for patients with NVUGIH.Methods:A total of 540 hospitalized patients with NVUGIH were included in our study.Patients who received endoscopy within 12 h or after 12 h were divided into two groups,the urgent and non-urgent endoscopy groups,respectively.The clinical outcomes including rebleeding,mortality,endoscopic re-intervention,need for emergency surgery and interventional radiotherapy were compared between the groups.Patients with Glasgow-Blatchford scores(GBS)＜12 and＞12 were defined as the lower-and high-risk groups,respectively,and the predictors of rebleeding and mortality in both groups were analyzed individually.Results:Patients with NVUGIH in the urgent endoscopy group had a higher rate of rebleeding(27.6％vs.16.9％,P=0.003)and blood transfusion(73.2％vs.55.5％,P＜0.001)than those in the non-urgent endoscopy group,while the mortality and the length of hospitalization were not significantly different between the groups(P＞0.05).For lower-risk patients,urgent endoscopy was independently associated with a higher likelihood of rebleeding(adjusted OR:1.73,95％CI:1.03-2.88),while it was not associated with in-hospital mortality.However,the urgent need for endoscopy was not associated with rebleeding and in-hospital mortality in high-risk patients.Conclusion:Endoscopy within 12 h did not provide any advantage in the outcomes of patients with NVUGIH,and may even lead to an increased rebleeding rate in lower-risk patients.

Jia-lun GUAN;Ying-ying HAN;Dan FANG;Mu-ru WANG;Ge WANG;De-an TIAN;Pei-yuan LI

Division of Gastroenterology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Gastroenterology,Wenchang People's Hospital,Wenchang 571300,China

当代医学科学(英文)

[1]Jia-lun GUAN;Ying-ying HAN;Dan FANG;Mu-ru WANG;Ge WANG;De-an TIAN;Pei-yuan LI-.Urgent Endoscopy in Nonvariceal Upper Gastrointestinal Hemorrhage:A Retrospective Analysis)[J].当代医学科学(英文),2022(04):856-862

Urgent,Nonvariceal,NVUGIH,rebleeding

Endoscopy,Upper,Gastrointestinal,Hemorrhage,Retrospective,Analysis,Objective,role,urgent,endoscopy,nonvariceal,upper,gastrointestinal,hemorrhage,remains,controversial,We,designed,retrospective,study,outcomes,between,within,patients,Methods,total,hospitalized,were,included,our,Patients,who,received,after,divided,into,two,groups,respectively,clinical,including,mortality,endoscopic,need,emergency,surgery,interventional,radiotherapy,compared,Glasgow,Blatchford,scores,GBS,defined,lower,risk,predictors,both,analyzed,individually,Results,had,higher,rate,blood,transfusion,than,those,while,length,hospitalization,not,significantly,different,For,was,independently,associated,likelihood,adjusted,However,Conclusion,did,provide,any,advantage,may,even,lead,increased

0.415008