Transcatheter arterial embolization vs surgical intervention for acute upper gastrointestinal bleeding: long-term...

This study aimed to compare the long-term efficacy and survival between transcatheter arterial embolization (TAE) and surgical intervention in patients with acute upper gastrointestinal bleeding (AUGIB).

This single-center retrospective study included 352 patients with AUGIB (2020-2023). After 1:1 propensity score matching, 200 patients were analyzed (100 who underwent TAE and 100 who underwent subtotal gastrectomy). All patients were followed up for 2 years. Treatment effectiveness, length of hospital stay, time to oral intake, rebleeding rates, complication rates, and 2-year survival were compared. Least absolute shrinkage and selection operator (LASSO) and Cox regression analyzes identified prognostic factors.

Overall treatment effectiveness was similar between the groups (P =.442). Patients in the TAE group had a shorter length of hospital stay (P <.001) and lower complication rates (P =.030), but higher rebleeding rates (P =.041). Two-year survival did not differ significantly (P =.355). LASSO and Cox regression analyzes identified age, diabetes, and rebleeding as independent predictors of mortality (all P <.05).

TAE and surgery yield comparable long-term survival rates. Surgery offers better hemostasis for preventing rebleeding, whereas TAE reduces the length of hospital stay and complication rates. Age, diabetes, and rebleeding are key prognostic factors for mortality in patients with AUGIB.