ArticleCanadian journal of gastroenterology & hepatology2014
Adherence to guidelines: a national audit of the management of acute upper gastrointestinal bleeding. The REASON registry.
Article in Canadian journal of gastroenterology & hepatology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Quality indicators for upper GI endoscopy.Gastrointestinal endoscopy · 2025Guideline
- Comprehensive review on the current management of upper-GI bleed.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Review
- Article
- Minutes to Save a Life in Acute GI Bleeding: A Systematic Review of Early vs. Delayed Endoscopy.Cureus · 2025Review
- Usability and adoption in a randomized trial of GutGPT a GenAI tool for gastrointestinal bleeding.NPJ digital medicine · 2025Article
- Expert of Experts Verification and Alignment (EVAL) Framework for Large Language Models Safety in Gastroenterology.NPJ digital medicine · 2025Article
- Quality Indicators for Upper GI Endoscopy.The American journal of gastroenterology · 2025Article
- The Future is Bright (Red) for Hemostasis of Peptic Ulcers.Digestive diseases and sciences · 2024Article
- Pre-Endoscopic Scores Predicting Low-Risk Patients with Upper Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Review
- Intermittent Proton Pump Inhibitor Therapy in Low-Risk Non-Variceal Upper Gastrointestinal Bleeding May Be Significantly Cost-Saving.Medicines (Basel, Switzerland) · 2023Article
- Increasing inpatient mortality of nonvariceal upper gastrointestinal bleeding during the COVID-19 pandemic: a nationwide retrospective cohort study.Proceedings (Baylor University. Medical Center) · 2023Article
- An update on the management of non-variceal upper gastrointestinal bleeding.Gastroenterology report · 2023Review
- Forrest Classification for Bleeding Peptic Ulcer: A New Look at the Old Endoscopic Classification.Diagnostics (Basel, Switzerland) · 2022Article
- Current Status and Future Perspective of Artificial Intelligence in the Management of Peptic Ulcer Bleeding: A Review of Recent Literature.Journal of clinical medicine · 2021Review
- Article
- In-hospital acute upper gastrointestinal bleeding: What is the scope of the problem?World journal of gastrointestinal endoscopy · 2019Article
- A Newly Designed 3-Dimensional Printer-Based Gastric Hemostasis Simulator with Two Modules for Endoscopic Trainees (with Video).Gut and liver · 2019Article
- Timing or Dosing of Intravenous Proton Pump Inhibitors in Acute Upper Gastrointestinal Bleeding Has Low Impact on Costs.The American journal of gastroenterology · 2016Article
- Diagnosis and therapy of non-variceal upper gastrointestinal bleeding.World journal of gastrointestinal pharmacology and therapeutics · 2015Review
- Development and validation of machine learning models to predict the need for haemostatic therapy in acute upper gastrointestinal bleeding.Therapeutic advances in gastrointestinal endoscopyArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess process of care in nonvariceal upper gastrointestinal bleeding (NVUGIB) using a national cohort, and to identify predictors of adherence to 'best practice' standards.
methodsConsecutive charts of patients hospitalized for acute upper gastrointestinal bleeding across 21 Canadian hospitals were reviewed. Data regarding initial presentation, endoscopic management and outcomes were collected. Results were compared with 'best practice' using established guidelines on NVUGIB. Adherence was quantified and independent predictors were evaluated using multivariable analysis.
resultsOverall, 2020 patients (89.4% NVUGIB, variceal in 10.6%) were included (mean [± SD] age 66.3±16.4 years; 38.4% female). Endoscopy was performed in 1612 patients: 1533 with NVUGIB had endoscopic lesions (63.1% ulcers; high-risk stigmata in 47.8%). Early endoscopy was performed in 65.6% and an assistant was present in 83.5%. Only 64.5% of patients with high-risk stigmata received endoscopic hemostasis; 9.8% of patients exhibiting low-risk stigmata also did. Intravenous proton pump inhibitor was administered after endoscopic hemostasis in 95.7%. Rebleeding and mortality rates were 10.5% and 9.4%, respectively. Multivariable analysis revealed that low American Society of Anesthesiologists score patients had fewer assistants present during endoscopy (OR 0.63 [95% CI 0.48 to 0.83), a hemoglobin level <70 g⁄L predicted inappropriate high-dose intravenous proton pump inhibitor use in patients with low-risk stigmata, and endoscopies performed during regular hours were associated with longer delays from presentation (OR 0.33 [95% CI 0.24 to 0.47]).
conclusionThere was variability between the process of care and 'best practice' in NVUGIB. Certain patient and situational characteristics may influence guideline adherence. Dissemination initiatives must identify and focus on such considerations to improve quality of care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.