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Differences in emergency endoscopy outcomes according to gastrointestinal bleeding location
Minoru Fujita1, Noriaki Manabe1, Takahisa Murao2
1Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan.
Scandinavian Journal of Gastroenterology
|November 17, 2020
Summary
Patients with upper gastrointestinal bleeding (UGIB) have a worse prognosis than those with lower gastrointestinal bleeding (LGIB). Emergency endoscopy outcomes differ based on bleeding location, impacting patient prognosis.
Area of Science:
- Gastroenterology
- Endoscopy
- Clinical Outcomes Research
Background:
- Gastrointestinal (GI) bleeding management has advanced with endoscopic hemostasis.
- Limited data exists on the comparative clinical course of upper vs. lower GI bleeding.
- Prognostic factors and outcomes require further investigation.
Purpose of the Study:
- To compare clinical outcomes between upper GI bleeding (UGIB) and lower GI bleeding (LGIB).
- To identify factors influencing prognosis in patients with GI bleeding.
- To analyze the impact of emergency endoscopy based on bleeding location.
Main Methods:
- Retrospective review of 1697 patients undergoing emergency endoscopy for GI bleeding.
- Assessment of bleeding severity using Glasgow-Blatchford (GB), AIMS65, and NOBLADS scores.
- Definition of rebleeding as relapse or persistent iron deficiency anemia post-endoscopy.
Main Results:
- UGIB patients (1054) showed higher rebleeding rates and mortality than LGIB patients (643).
- GB score ≥12 and AIMS65 score ≥2 predicted rebleeding in UGIB.
- NOBLADS score ≥4 predicted rebleeding in LGIB.
- Emergency endoscopy's effectiveness varied by GI bleeding location.
Conclusions:
- Upper GI bleeding (UGIB) is associated with a significantly worse clinical course compared to lower GI bleeding (LGIB).
- The impact of emergency endoscopy is location-dependent in GI bleeding management.
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