An observational study on the time of endoscopy for nonvariceal upper gastrointestinal bleeding

Aims In cases of non-variceal upper gastrointestinal bleeding (NVUGIB), endoscopic intervention within the first 24 hours is widely recommended. However, data on the efficacy of urgent endoscopy are limited. Here we analyzed bleeding outcomes according to time to endoscopy using Glasgow-Blatchford score (GBS).

Methods We retrospectively reviewed the prospectively collected multicenter data, which included 1554 patients with NVUGI. Based on time-to-endoscopy, patients were grouped into the early (< 24 hours) versus the delayed (≥ 24 hours) group and the urgent (< 6 hours) versus the non-urgent (≥ 6 hours) group. The rates of re-bleeding, mortality, secondary intervention, transfusion, and morbidity aggravation were analyzed.

Results The mean time to endoscopy and median GBS were 33.0±75.5 hours and 12 (range, 1–23), respectively. Univariate analyses revealed that in the delayed endoscopy group, the transfusion and re-bleeding rates were higher (hazard ratio [HR]: 1.257, 95% confidence interval [CI]: 1.026–1.540) and lower (HR: 0.610, 95% CI: 0.413–0.901), respectively. Multivariate analysis revealed that delayed endoscopy was a significant factor for lower re-bleeding rate (HR: 0.576, 95% CI: 0.387–0.859), which was prominent in the low-risk group (HR: 0.417, 95% CI: 0.225–0.774). Multivariate analysis showed that when compared with the low-risk group, in-hospital comorbidity aggravation was more common in high-risk patients who underwent non-urgent endoscopy (HR: 2.957, 95% CI: 1.045–6.454).

Conclusions In low-risk patients, delayed endoscopy is sufficient for NVUGIB management. In high-risk patients, urgent endoscopy reduced comorbidity aggravation during hospital care.

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025