Emergency Endoscopic Interventions in Acute Upper Gastrointestinal Bleeding: A Cohort Study

Area of Science:

• Gastroenterology
• Emergency Medicine
• Endoscopy

Background:

• Acute upper gastrointestinal bleeding (AUGIB) is a frequent reason for emergency department visits.
• Upper gastrointestinal endoscopy is the standard diagnostic and treatment approach for AUGIB.
• Limited research exists on the efficacy of nighttime emergency endoscopy compared to daytime procedures.

Purpose of the Study:

• To evaluate the effectiveness of emergency therapeutic gastroscopy for AUGIB during nighttime hours.
• To compare outcomes of daytime versus nighttime emergency endoscopy for AUGIB treatment.

Main Methods:

• A retrospective cohort study analyzed adult patients with AUGIB undergoing emergency endoscopy.
• Patients were divided into day-hours and night-hours groups based on gastroscopy timing.
• Primary endpoint was 120-day all-cause mortality; secondary endpoints included hemostasis and recurrence.

Main Results:

• 160 patients underwent nighttime endoscopy (10 PM - 8 AM), while 592 had daytime procedures (8 AM - 10 PM).
• Nighttime endoscopy had a shorter duration to hemostasis (p < 0.001).
• All-cause mortality was not significantly different between groups, though higher in the nighttime group.

Conclusions:

• Emergency therapeutic gastroscopy for AUGIB demonstrates similar effectiveness during both day and night hours.
• Endoscopic intervention after six hours from symptom onset is associated with improved outcomes.
• Timely intervention is crucial, with poorer outcomes noted for treatment before five hours.