Outcomes and Role of Urgent Endoscopy in High-Risk Patients With Acute Nonvariceal Gastrointestinal Bleeding

Cho, Soo-Han; Lee, Yoon‐Seon; Kim, Youn-Jung; Sohn, Chang Hwan; Kim, Won Young; Seo, Dong-Woo; Lee, Jae Ho; Lim, Kyoung Soo

doi:10.1016/j.cgh.2017.06.029

Cited by 92 publications

(92 citation statements)

References 26 publications

(39 reference statements)

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“…Several studies have shown that early endoscopy might benefit high-risk patients, especially in reducing the mortality rate. Cho et al [18] showed that urgent endoscopy (<6 h) for high-risk patients (GBS >7) with acute non-variceal UGIB was an independent predictor of lower mortality rate. Another study by Lim et al [19] showed that endoscopy performed within 13 hours of presentation was associated with lower mortality in high-risk patients (GBS ≥12).…”

Section: Discussionmentioning

confidence: 99%

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Hemospray® during Emergency Endoscopy: Indonesia’s First Experience from 37 Patients

Bestari

Joewono

Girawan

et al. 2020

Case Rep Gastroenterol

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Section: Discussionmentioning

confidence: 99%

“…Of the 37 patients, the mortality rate was 37.8% (n = 14), with an average GBS upon admission of 16.2 (range [14][15][16][17][18]. The increase of GBS was due to other causes such as hepatic disease and heart failure, and more severe hemodynamic instability.…”

Section: Mortalitymentioning

confidence: 98%

Hemospray® during Emergency Endoscopy: Indonesia’s First Experience from 37 Patients

Bestari

Joewono

Girawan

et al. 2020

Case Rep Gastroenterol

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“…Definitive endoscopic treatment should not be unduly delayed if the patient remains haemodynamically unstable despite adequate resuscitation measures 2829. However, where the patient is stable, or becomes so after resuscitation, the optimal timing of the initial endoscopy is debatable 2630.…”

Section: How Might You Manage Patients Initially?mentioning

confidence: 99%

Acute upper gastrointestinal bleeding

Sverdén

Markar

Agréus

et al. 2018

BMJ

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“…The Glasgow-Blatchford Score (GBS) has been acknowledged as the most accurate prediction score system for therapeutic intervention and mortality [7]. Patients with a GBS score < 3 who do not need hospitalization are considered low-risk, whereas patients with a GBS score ≥ 7 are considered high-risk and recommended to undergo urgent endoscopy within 24 hours; this is considered to be the best score to predict mortality and demand for urgent endoscopic intervention [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…In clinical practice, lower hemoglobin levels in NUGIB patients are usually associated with severe clinical episodes, including mortality, recurrent hemorrhage and blood transfusion [1,[8][9][10][11][12]. In high-risk patients, anemia is relatively common, but the role of anemia on the prognosis of endoscopic intervention remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Impact of Anemia on the Outcomes of Endoscopic Intervention in High-Risk NUGIB Patients

Tan

Lan

Bai

et al. 2020

Preprint

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Background: It is common for high-risk, non-variceal upper gastrointestinal bleeding (NUGIB) patients coexisting anemia, but the role of anemia on the prognosis of endoscopic intervention is not clear. The aim of this study was to assess the impact of hemoglobin level on outcomes of endoscopic intervention in high-risk NUGIB patients. Methods: A retrospective study was performed on high-risk (Glasgow-Blatchford score ≥7) NUGIB patients who underwent endoscopic intervention within 24h of presentation. Patients were divided into three groups based on hemoglobin level before intervention: severe (<7g/dl), moderate (7g/dl ≤hemoglobin <9g/dl) and mild (≥9g/dl) group. Outcomes included mortality, length of ICU stay, re-bleeding rate, procedural adverse events, length of hospital stay, adverse events and transfusion requirement. Results: A total of 156 patients received endoscopic intervention were identified, 88 in the severe group, 45 in the moderate group, and 23 in the mild group. The total mortality rate in 45 days was 2%, and the re-bleeding rate was 21%. There was no significant difference in mortality, re-bleeding rate or length of ICU stay among the three groups. The average days of hospitalization in the severe group was significantly longer than that of the moderate group (13 vs 8, P < 0.05). No adverse events occurred. Low hemoglobin level was a predictor for more red-cell transfusion (OR=5.94, 2.69-13.11) and plasma transfusion (OR=2.34,1.21-4.51). Conclusions: Anemia does not affect the mortality and rebleeding of endoscopic intervention in high-risk NUGIB patients, but is associated with more transfusion and longer hospitalization.

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Outcomes and Role of Urgent Endoscopy in High-Risk Patients With Acute Nonvariceal Gastrointestinal Bleeding

Cited by 92 publications

References 26 publications

Hemospray® during Emergency Endoscopy: Indonesia’s First Experience from 37 Patients

Hemospray® during Emergency Endoscopy: Indonesia’s First Experience from 37 Patients

Acute upper gastrointestinal bleeding

Impact of Anemia on the Outcomes of Endoscopic Intervention in High-Risk NUGIB Patients

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Outcomes and Role of Urgent Endoscopy in High-Risk Patients With Acute Nonvariceal Gastrointestinal Bleeding

Cited by 92 publications

References 26 publications

Hemospray® during Emergency Endoscopy: Indonesia’s First Experience from 37 Patients

Hemospray® during Emergency Endoscopy: Indonesia’s First Experience from 37 Patients

Acute upper gastrointestinal bleeding

Impact of Anemia on the Outcomes of Endoscopic Intervention in&nbsp;High-Risk NUGIB Patients

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Impact of Anemia on the Outcomes of Endoscopic Intervention in High-Risk NUGIB Patients