Timing of endoscopy and its impact on prognosis in patients admitted to the emergency department with upper gastrointestinal bleeding
Irish Journal of Medical Science, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s11845-026-04561-2
- Dergi Adı: Irish Journal of Medical Science
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: Upper gastrointestinal bleeding, Endoscopy timing, Mortality, Emergency department, Blood transfusion
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Acute upper gastrointestinal bleeding (UGIB) is a life-threatening emergency associated with substantial morbidity and mortality. Current guidelines recommend endoscopy within 24 hours; however, the additional clinical benefit of very early (≤6 hours) endoscopy remains unclear. Aims: This study aimed to evaluate the effect of very early endoscopy performed within the first 6 hours on clinical outcomes in patients presenting to the emergency department with UGIB, compared with procedures performed within 6–24 hours. Methods: In this retrospective observational study, adult patients admitted to a tertiary care emergency department between June 2022 and June 2024 with confirmed UGIB were included. Endoscopy performed within 6 hours was defined as early endoscopy. Patients were categorized into two groups (≤6 hours and 6–24 hours) based on timing. Demographic characteristics, clinical findings, transfusion requirements, rebleeding, and 30-day mortality were analyzed. Results: A total of 326 patients were evaluated. Overall mortality was 8.9%, with no significant difference between groups. However, erythrocyte suspension and fresh frozen plasma use were significantly higher in the 6–24 hour group. Time to endoscopy was longer in patients requiring transfusion. Rebleeding rates and hospital stay were similar between groups. A higher shock index was associated with increased mortality. Conclusion: Endoscopy performed within the first 6 hours does not provide additional clinical benefit compared with procedures performed within 6–24 hours. Adequate resuscitation and timely endoscopy remain the key determinants of clinical outcomes.