Influence of Endoscopy Timing on Prognosis of Patients With Peptic Ulcer Bleeding
10.3969/j.issn.1008-7125.2024.12.005
- VernacularTitle:消化性溃疡出血的内镜检查时机对患者预后的影响
- Author:
Huiqin HU
1
;
Bingsheng LI
1
Author Information
1. 广东省惠州市第一人民医院消化内科(516003)
- Publication Type:Journal Article
- Keywords:
Peptic Ulcer Bleeding;
Endoscopic Timing;
Rebleeding;
Adverse Outcomes
- From:
Chinese Journal of Gastroenterology
2024;29(12):727-730
- CountryChina
- Language:Chinese
-
Abstract:
Background:Peptic ulcer bleeding(PUB)is the main cause of acute upper gastrointestinal bleeding.Currently,endoscopic examination within 24 hours is recommended for patients with acute upper gastrointestinal bleeding,but the optimal timing within 24 hours remains uncertain.Aims:To study the impact of endoscopic timing on the prognosis of patients with PUB.Methods:A retrospective analysis was conducted on patients who presented to Huizhou First Hospital with symptoms of gastrointestinal bleeding(hematemesis,melena,and bloody stools)from 2019 to 2022 and were diagnosed with PUB by gastroscopy within 24 hours.Their basic clinical data were collected.According to the endoscopic timing after admission,they were divided into urgent endoscopy group(≤8 hours after admission)and emergent endoscopy group(8-24 hours after admission).The 30-day rebleeding rate,the rates of adverse in-hospital outcomes,hospitalization costs,length of hospital stay,and blood transfusion rates were compared between the two groups.Results:A total of 608 patients were included in this study.The 30-day rebleeding rate was 6.6%.No significant differences in the 30-day rebleeding rate(5.3%vs.7.5%,P=0.275),the rate of adverse in-hospital outcomes in was(3.8%vs.7.2%,P=0.071),length of hospital stay and blood transfusion rate were found between the urgent endoscopy group emergent endoscopy group The hospitalization cost in the urgent endoscopy group was significantly higher than that in the emergent endoscopy group(P=0.002).There were 376 patients with high-risk ulcers.The 30-day rebleeding rate was 10.4%and the rate of adverse in-hospital outcomes was 7.2%.The 30-day rebleeding rate(7.3%vs.13.7%,P=0.042),the rate of adverse in-hospital outcomes(4.1%vs.10.4%,P=0.019)in the urgent endoscopy group were significantly lower than those in the emergent endoscopy group.There were no significant differences in hospitalization cost,length of hospital stay,and blood transfusion rate between the two groups.Conclusions:Urgent endoscopy within 8 hours after admission in patients with PUB does not reduce the 30-day rebleeding rate and the rate of adverse in-hospital outcomes.However,patients with high-risk ulcers seem more likely to benefit from emergency endoscopy within 8 hours.
