Korean J Gastroenterol.  2009 Apr;53(4):228-234.

Effect of After-hours Emergency Endoscopy on the Outcome of Acute Upper Gastrointestinal Bleeding

• Kim Y
• Kim SG
• Kang HY
• Kang HW
• Kim JS
• Jung HC
• Song IS

Abstract

BACKGROUND/AIMS: Gastrointestinal endoscopy is imperative for acute upper gastrointestinal bleeding (AUGIB) to find bleeding focus and stop bleeding. This study was designed to assess the necessity of emergency endoscopy and determine screening criteria for the patients who presented to emergency room (ER) with after-hours AUGIB.
METHODS
The medical records of 383 patents with AUGIB who presented to ER at after-hours were reviewed. Patients were divided into 2 groups: emergency endoscopy (EE) group (<12 hours after arrival) or delayed endoscopy (DE) group (12-24 hours after arrival). We compared the severity, hemostatic procedures, rebleeding rate, length of hospitalization and 30-day mortality between the two groups.
RESULTS
Ninety-eight patients in EE group and 137 patients in DE group were evaluated among patients with non-variceal upper gastrointestinal bleeding. No significant differences in clinical severity, finding the bleeding focus, hemostasis, 30-day mortality, hospital stay, and rebleeding rate were observed between the two groups. Among 148 patients with variceal upper gastrointestinal bleeding, 65 patients were in EE group and 83 patients in DE group. Most clinical severity index were not different between the groups. In EE group, the rate of finding bleeding foci was lower (p=0.043), and 30-day mortality was higher than in DE group (p=0.023). CONCLUSIONS: Emergency endoscopy within 12 hours after arrival at after-hours do not lead to better prognosis in AUGIB.

Keyword

Emergency endoscopy; Hemostasis; Acute gastrointestinal bleeding

MeSH Terms

Acute Disease
Adult
Aged
Clinical Competence
*Emergency Service, Hospital
*Endoscopy, Gastrointestinal
Female
Gastrointestinal Hemorrhage/*diagnosis/mortality/therapy
Humans
Length of Stay
Male
Middle Aged
Prognosis
Retrospective Studies
Risk Factors
Severity of Illness Index
Time Factors
Treatment Outcome