Can we find a precise timing for endoscopic intervention in gastrointestinal bleeding?

Kusano, Chika

doi:10.1111/den.14265

Cited by 1 publication

(1 citation statement)

References 10 publications

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“…It is well known that the execution of upper endoscopy at the proper time is key to correctly managing patients with upper gastrointestinal bleeding (UGIB) [ 1 ]. The timing of endoscopic examinations not only has an impact on clinical outcomes (i.e., mortality, re-bleeding, need for surgery, etc.)…”

Section: Introductionmentioning

confidence: 99%

Defining Time in Acute Upper Gastrointestinal Bleeding: When Should We Start the Clock?

Marmo¹,

Soncini

Bucci³

et al. 2023

JCM

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Introduction: The execution of upper endoscopy at the proper time is key to correctly managing patients with upper gastrointestinal bleeding (UGIB). Nonetheless, the definition of “time” for endoscopic examinations in UGIB patients is imprecise. The primary aim of this study was to verify whether the different definitions of “time” (i.e., the symptoms-to-endoscopy and presentation-to-endoscopy timeframes) impact mortality. The secondary purpose of this study was to evaluate the similarity between the two timeframes. Methods: A post-hoc analysis was performed on a prospective multicenter cohort study, which included UGIB patients admitted to 50 Italian hospitals. We collected the timings from symptoms and presentation to endoscopy, together with other demographic, organizational and clinical data and outcomes. Results: Out of the 3324 patients in the cohort, complete time data were available for 3166 patients. A significant difference of 9.2 h (p < 0.001) was found between the symptoms-to-endoscopy vs. presentation-to-endoscopy timeframes. The symptoms-to-endoscopy timeframe demonstrated (1) a different death risk profile and (2) a statistically significant improvement in the prediction of mortality risk compared to the presentation-to-endoscopy timeframe (p < 0.0002). The similarity between the two different timeframes was moderate (K = 0.42 ± 0.01; p < 0.001). Conclusions: The symptoms-to-endoscopy and presentation-to-endoscopy timeframes referred to different timings during the management of upper endoscopy in bleeding patients, with the former being more accurate in correctly identifying the mortality risk of these patients. We suggest that further studies be conducted to validate our observations, and, if confirmed, a different definition of time should be adopted in endoscopy.

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Section: Introductionmentioning

confidence: 99%

Defining Time in Acute Upper Gastrointestinal Bleeding: When Should We Start the Clock?

Marmo¹,

Soncini

Bucci³

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

Can we find a precise timing for endoscopic intervention in gastrointestinal bleeding?

Abstract: This Editorial refers to the article by J.Y.W. Lau, p https://doi.org/10.1111/den.14144 of this issue DEN 34:2.

Cited by 1 publication

References 10 publications

Defining Time in Acute Upper Gastrointestinal Bleeding: When Should We Start the Clock?

Defining Time in Acute Upper Gastrointestinal Bleeding: When Should We Start the Clock?

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