Out-of-hours endoscopy for non-variceal upper gastrointestinal bleeding

Area of Science:

• Gastroenterology
• Emergency Medicine
• Healthcare Management

Background:

• Many countries lack coordinated out-of-hours endoscopy services.
• Economic constraints and resource limitations are key barriers to emergency endoscopy access.

Purpose of the Study:

• To evaluate the performance of an out-of-hours emergency endoscopy model.
• To assess the effectiveness and safety of this model for acute upper gastrointestinal bleeding.

Main Methods:

• Prospective data collection over 3 years (2010-2012) from 332 outpatients with non-variceal acute upper gastrointestinal bleeding.
• Comparison of outcomes between direct admissions and patients transferred from other hospitals.

Main Results:

• 90% of patients received upper endoscopy within 24 hours.
• No significant differences in rebleeding, mortality, or need for surgery between direct admissions and transferred patients.
• Age, malignancy, and high Rockall score predicted in-hospital mortality.

Conclusions:

• The emergency endoscopy model enhanced access and equity for out-of-hours care.
• The model proved effective, safe, and timely, with consistent outcomes across patient groups.
• This approach offers a viable solution for managing emergency gastrointestinal bleeding.