Evaluation of endoscopy timing in patients with acute upper gastrointestinal bleeding in emergency department

Authors : Guner YURTSEVER

Pages : 959-965

Doi:10.16899/jcm.1341380

View : 18 | Download : 33

Publication Date : 2023-09-30

Article Type : Research Paper

Abstract :Background: Endoscopy is recommended in acute upper gastrointestinal bleeding insert ignore into journalissuearticles values(AUGIB); to detect the bleeding source and stop the bleeding. The optimal timing of endoscopy in AUGIB is controversial. We aimed to investigate the time of endoscopy and the factors affecting it. Materials and methods: Retrospective, single-center study. The patients were divided into four groups: endoscopy after discharge, 0-12 hours endoscopy, 12-24 hours endoscopy and 24 hours later. Age, sex, vital signs, laboratory findings were recorded. Glasgow-Blatchford Score insert ignore into journalissuearticles values(GBS); and Charlson comorbidity index insert ignore into journalissuearticles values(CCI); were calculated. The obtained data were compared between these four groups. All-cause mortality for 30 days was recorded. Results: A total of 318 patients were included. In the comparison of endoscopy times, the parameters found to be statistically significant between the four groups are Hb, BUN, and INR levels, GBS and CCI. As a result of CHAID analysis, the most crucial variable affecting the timing of endoscopy was found to be the Hb value of the patients insert ignore into journalissuearticles values(χ2=66.528; adjusted p=0.000);. Mortality occurred in 10.69% of the patients. The timing of endoscopy did not affect mortality. In binary logistic regression analysis, low systolic BP insert ignore into journalissuearticles values(0.967 times increase);, high CCI insert ignore into journalissuearticles values(86,402 times increase); were found to affect mortality. Conclusion: The factors affecting the timing of endoscopy are the signs of bleeding. A thorough follow-up of vital signs in patients presenting to the emergency department with acute gastrointestinal bleeding, particularly an evaluation of systolic blood pressure and detailed questioning of additional comorbid conditions, is critical to reduce mortality.
Keywords : endoskopi zamanlaması, acil durum, üst gastrointestinal kanama, akut gastrointestinal kanama