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Outpatient management for low-risk nonvariceal upper GI bleeding: a randomized controlled trial
Livio Cipolletta1, Maria Antonia Bianco, Gianluca Rotondano
1Department of Gastroenterology and Digestive Endoscopy, Regione Campania and the Ospedale Maresca, Torre del Greco, Italy.
Gastrointestinal Endoscopy
|January 5, 2002
Summary
Outpatient care is safe for low-risk patients with nonvariceal upper GI hemorrhage. This approach significantly reduces healthcare costs compared to traditional inpatient treatment, demonstrating its economic viability.
Area of Science:
- Gastroenterology
- Clinical Medicine
- Health Economics
Background:
- Acute nonvariceal upper GI hemorrhage typically leads to hospitalization, irrespective of patient condition.
- This study investigates the efficacy of outpatient management for low-risk patients with nonvariceal upper GI hemorrhage.
Purpose of the Study:
- To compare the outcomes of outpatient versus inpatient care for patients with nonvariceal upper GI hemorrhage who are at low risk for bleeding recurrence.
- To assess the safety and cost-effectiveness of early discharge and outpatient management.
Main Methods:
- Ninety-five low-risk patients were randomized into early discharge/outpatient care (48) or hospital care (47) groups.
- Patients were monitored daily by primary care physicians and by telephone by a gastroenterologist for 30 days.
- Key outcomes included rates of recurrent bleeding, hospitalization, surgery, and mortality.
Main Results:
- No significant difference in recurrent bleeding rates between groups (2.1% outpatient vs. 2.2% inpatient).
- No surgeries or deaths occurred in either group.
- Median costs were substantially lower for the outpatient group ($340) compared to the inpatient group ($3940).
Conclusions:
- Outpatient management is a safe and effective strategy for low-risk patients with nonvariceal upper GI hemorrhage.
- Early discharge and outpatient care can result in significant cost savings for the healthcare system.