Irish journal of medical science · 2026
Timing of endoscopy and its impact on prognosis in patients admitted to the emergency department with upper gastrointestinal bleeding.
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Gorur Mehmet, Satar Salim, Gulen Muge, Acehan Selen, Sevdimbas Sarper, Nigiz Kadir
Аннотация
BACKGROUND: Acute upper gastrointestinal bleeding (UGIB) is a life-threatening emergency associated with substantial morbidity and mortality. Current guidelines recommend endoscopy within 24 hours; however, the additional clinical benefit of very early (≤6 hours) endoscopy remains unclear.
AIMS: This study aimed to evaluate the effect of very early endoscopy performed within the first 6 hours on clinical outcomes in patients presenting to the emergency department with UGIB, compared with procedures performed within 6-24 hours.
METHODS: In this retrospective observational study, adult patients admitted to a tertiary care emergency department between June 2022 and June 2024 with confirmed UGIB were included. Endoscopy performed within 6 hours was defined as early endoscopy. Patients were categorized into two groups (≤6 hours and 6-24 hours) based on timing. Demographic characteristics, clinical findings, transfusion requirements, rebleeding, and 30-day mortality were analyzed.
RESULTS: A total of 326 patients were evaluated. Overall mortality was 8.9%, with no significant difference between groups. However, erythrocyte suspension and fresh frozen plasma use were significantly higher in the 6-24 hour group. Time to endoscopy was longer in patients requiring transfusion. Rebleeding rates and hospital stay were similar between groups. A higher shock index was associated with increased mortality.
CONCLUSION: Endoscopy performed within the first 6 hours does not provide additional clinical benefit compared with procedures performed within 6-24 hours. Adequate resuscitation and timely endoscopy remain the key determinants of clinical outcomes.
AIMS: This study aimed to evaluate the effect of very early endoscopy performed within the first 6 hours on clinical outcomes in patients presenting to the emergency department with UGIB, compared with procedures performed within 6-24 hours.
METHODS: In this retrospective observational study, adult patients admitted to a tertiary care emergency department between June 2022 and June 2024 with confirmed UGIB were included. Endoscopy performed within 6 hours was defined as early endoscopy. Patients were categorized into two groups (≤6 hours and 6-24 hours) based on timing. Demographic characteristics, clinical findings, transfusion requirements, rebleeding, and 30-day mortality were analyzed.
RESULTS: A total of 326 patients were evaluated. Overall mortality was 8.9%, with no significant difference between groups. However, erythrocyte suspension and fresh frozen plasma use were significantly higher in the 6-24 hour group. Time to endoscopy was longer in patients requiring transfusion. Rebleeding rates and hospital stay were similar between groups. A higher shock index was associated with increased mortality.
CONCLUSION: Endoscopy performed within the first 6 hours does not provide additional clinical benefit compared with procedures performed within 6-24 hours. Adequate resuscitation and timely endoscopy remain the key determinants of clinical outcomes.