Endoscopy-based triage significantly reduces hospitalization rates and costs of treating upper GI bleeding: a randomized controlled trial

Is Early Endoscopy in the Emergency Room Beneficial in Patients with Bleeding Peptic Ulcer? A ”Fortuitously Controlled” Study

“…Other studies have shown that combined pharmacological and endoscopie treatment is superior to endoscopie treatment alone, but does not increase the 15-day survival in variceal bleeding [18,19]. Furthermore, the same critisisms apply to all prospective trials of ulcer bleeding which attempt to address strategies for diagnostic and therapeutic endoscopy [5,6]. A study of patients with ail types of upper gastrointestinal bleeding needs to be done in order to address the question of the overall value of EEE.…”

“…It favorably affects recurrent bleeding, the need for surgery, and, probably, survival [1][2][3][4]. The question of whether endoscopie hemostasis should be performed early after hospital admission has also been examined in randomized trials [5,6], in observational cohort studies [7][8][9], and in a systematic review [10], and these papers have described early endoscopy as advantageous. However, it is difficult the Baylor bleeding score and the Rockall score), and differed only in the treatment they received.…”

Upper Gastrointestinal Bleeding (UGB): Causes and Treatment

“…The majority of data published suggest that early endoscopy (generally defined as endoscopy within 24 hours) is safe and can reduce transfusion requirements and length of hospital admission.12 However, no mortality benefit could be identified with early endoscopy. Several studies have investigated the efficacy of urgent endoscopy (endoscopy performed with 6 or 12 hours) compared with elective endoscopy [3][4][5]. The results of these studies suggest that urgent endoscopy can reduce hospital stay and amount of blood transfusion.…”

Aspectos endoscópicos no manejo da úlcera péptica gastroduodenal

“…O exame endoscópico deve ser realizado nas primeiras 12 horas, após a avaliação e estabilização hemodinâmica (Tabela 6). A EDA realizada precocemente oferece importantes vantagens: a) permite detectar aqueles pacientes com lesões de baixo risco e que podem receber alta precocemente 16,17 ; b) possibilita que os pacientes com lesões de alto risco sejam submetidos ao tratamento hemostático que diminui a recidiva, pode evitar o tratamento cirúrgico e diminuir a mortalidade 18,19 ; c) apresenta relação custo-benefício favorável já que diminui o período de internação dos pacientes com alto risco e as readmissões hospitalares 18 .…”