Improving outcomes from acute upper gastrointestinal bleeding: Table 1

Acute upper gastrointestinal bleeding in a tertiary care hospital in South India - Have we Improved the outcomes?

“…37,38 It is also suggested that improvement in care can be measured by the proportion of patients, in whom endoscopy was done within 24 hours. 39 In our study endoscopy was done within 24 to 48 hours only and all patient could not undergoendoscopy within 24 hours.…”

The Cost-Effectiveness Analysis of Video Capsule Endoscopy Compared to Other Strategies to Manage Acute Upper Gastrointestinal Hemorrhage in the Emergency Department

“…Age 65 years was chosen because that is the mean age of patients presenting to the ED with upper GI bleeds with a moderate to high risk of hemorrhage (Glasgow-Blatchford score >0) which represents over 90% of all patients with suspected upper GI bleeds. [7][8][9][10] We tested two scenarios with mild and moderate risks of requiring invasive hemostasis intervention (i.e, endoscopic, surgical, etc.) Our model assumed that the suspected upper GI bleed requires further evaluation and that the four diagnostic strategies were available: (1) direct imaging with video capsule endoscopy performed in the ED, (2) risk stratification using the Glasgow-Blatchford score, (3) nasogastric tube placement and finally, (4) an admit-all strategy in which every patient suspected of an upper GI hemorrhage is admitted to hospital.…”

“…7,10,20 The probability of re-bleeding after initial hemostasis was 12% and of these patients, there was a 30.6% probability of re-bleeding. 8 Patients who re-bled for a second time will have surgery to perform a duodenal or gastric suture and there is a risk of mortality from the procedure of 4%. 21 Costs-We used 2012 Medicare data for diagnosis related groups (DRGs) and relative value units (RVUs) as surrogates for facility and professional costs, respectively ( Table 2).…”

First-line endoscopic treatment with OTSC in patients with high-risk non-variceal upper gastrointestinal bleeding: preliminary experience in 40 cases

“…Keywords Non-variceal gastrointestinal bleeding Á Ulcers peptic and other Á Over-the-scope clip Á Endoscopy upper GI tract Despite major advances in the management of non-variceal upper gastrointestinal bleeding (NVUGIB) over the past decade including prevention of peptic ulcer bleeding, optimal use of endoscopic therapy and high-dose proton pump inhibition, this still carries considerable morbidity, mortality and health economic burden [1]. Of particular note are the re-bleeding rates, one of the most crucial predictive factors of morbidity and mortality that has not significantly improved as evident from longitudinal data in the past 15 years [2,3].…”