Evidence map›Paper›PMID 32242355›Full record

Trial reportThe New England journal of medicine2020

Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding.

James Y W Lau, Yuanyuan Yu, Raymond S Y Tang, Heyson C H Chan, Hon-Chi Yip, Shannon M Chan, Sally W Y Luk, Sunny H Wong, Louis H S Lau, Rashid N Lui and 4 more

4 registry-linked trialsAbstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 153 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
153citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT01675856 nacompletednot on this map

Urgent vs. Early Endoscopy in High Risk Patients With UGIB

TypeinterventionalSponsorChinese University of Hong KongRan2012 to 2018Enrolled516ConditionsBleeding Peptic Ulcer, Active Bleeding, Gastrointestinal BleedingArmsUrgent endoscopy, Early endoscopy
NCT04786743 nacompletednot on this mapstarted 2021, after this paper: background citation

Timing of Endoscopic Intervention in Patients With Cirrhosis With Acute Variceal Upper Gastrointestinal Hemorrhage (TEACH Trial): a Randomized Clinical Trial

TypeinterventionalSponsorJinling Hospital, ChinaRan2021 to 2026Enrolled412ConditionsAcute Upper Gastrointestinal Hemorrhage, Cirrhosis, Varice Bleed, Gastroesophageal VaricesArmsendoscopic intervention
NCT04932200 unknown statusnot on this mapstarted 2021, after this paper: background citation

A Prospective Multicenter Cohort Study on the Timing of Emergency Endoscopy for Esophagogastric Variceal Bleeding in Cirrhosis

TypeobservationalSponsorRenmin Hospital of Wuhan UniversityRan2021 to 2022Enrolled608ConditionsLiver Cirrhosis, Portal Hypertension, Esophageal Varix Bleeding
NCT04957875 completednot on this map

Timing of Endoscopy for Acute Variceal Bleeding in Patients With Cirrhosis (CHESS1905): a Nationwide Cohort Study

TypeobservationalSponsorHepatopancreatobiliary Surgery Institute of Gansu ProvinceRan2019 to 2020Enrolled3,300ConditionsCirrhosis, Liver, Portal Hypertension, Varice BleedArmsemergency endoscopic therapy
3 · Its place in the literature

Who cites it

153 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Quality indicators for upper GI endoscopy.Gastrointestinal endoscopy · 2025
    Guideline
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Review
  13. Article
  14. Comprehensive review on the current management of upper-GI bleed.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026
    Review
  15. Endoscopic Treatment of Upper Gastrointestinal Bleeding.The Korean journal of helicobacter and upper gastrointestinal research · 2026
    Review
  16. Article
  17. Article
  18. Article
  19. Review
  20. Management of Non-Variceal Upper Gastrointestinal Bleeding.The Korean journal of helicobacter and upper gastrointestinal research · 2026
    Review

93 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

James Y W LauFrom the Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, Hong Kong.ORCID 0000-0003-0122-4068
Yuanyuan YuFrom the Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, Hong Kong.
Raymond S Y TangFrom the Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, Hong Kong.
Heyson C H ChanFrom the Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, Hong Kong.
Hon-Chi YipFrom the Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, Hong Kong.
Shannon M ChanFrom the Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, Hong Kong.
Sally W Y LukFrom the Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, Hong Kong.
Sunny H WongFrom the Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, Hong Kong.
Louis H S LauFrom the Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, Hong Kong.
Rashid N LuiFrom the Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, Hong Kong.
Ting T ChanFrom the Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, Hong Kong.
Joyce W Y MakFrom the Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, Hong Kong.
Francis K L ChanFrom the Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, Hong Kong.
Joseph J Y SungFrom the Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, Hong Kong.

Funding

Food and Health Bureau 01120516
6 · The paper itself

Abstract

backgroundIt is recommended that patients with acute upper gastrointestinal bleeding undergo endoscopy within 24 hours after gastroenterologic consultation. The role of endoscopy performed within time frames shorter than 24 hours has not been adequately defined.

methodsTo evaluate whether urgent endoscopy improves outcomes in patients predicted to be at high risk for further bleeding or death, we randomly assigned patients with overt signs of acute upper gastrointestinal bleeding and a Glasgow-Blatchford score of 12 or higher (scores range from 0 to 23, with higher scores indicating a higher risk of further bleeding or death) to undergo endoscopy within 6 hours (urgent-endoscopy group) or between 6 and 24 hours (early-endoscopy group) after gastroenterologic consultation. The primary end point was death from any cause within 30 days after randomization.

resultsA total of 516 patients were enrolled. The 30-day mortality was 8.9% (23 of 258 patients) in the urgent-endoscopy group and 6.6% (17 of 258) in the early-endoscopy group (difference, 2.3 percentage points; 95% confidence interval [CI], -2.3 to 6.9). Further bleeding within 30 days occurred in 28 patients (10.9%) in the urgent-endoscopy group and in 20 (7.8%) in the early-endoscopy group (difference, 3.1 percentage points; 95% CI, -1.9 to 8.1). Ulcers with active bleeding or visible vessels were found on initial endoscopy in 105 of the 158 patients (66.4%) with peptic ulcers in the urgent-endoscopy group and in 76 of 159 (47.8%) in the early-endoscopy group. Endoscopic hemostatic treatment was administered at initial endoscopy for 155 patients (60.1%) in the urgent-endoscopy group and for 125 (48.4%) in the early-endoscopy group.

conclusionsIn patients with acute upper gastrointestinal bleeding who were at high risk for further bleeding or death, endoscopy performed within 6 hours after gastroenterologic consultation was not associated with lower 30-day mortality than endoscopy performed between 6 and 24 hours after consultation. (Funded by the Health and Medical Fund of the Food and Health Bureau, Government of Hong Kong Special Administrative Region; ClinicalTrials.gov number, NCT01675856.).

Indexed as

Endoscopy, GastrointestinalAcute DiseaseAgedEsophageal and Gastric VaricesFemaleGastrointestinal HemorrhageHospitalizationHumansKaplan-Meier EstimateMaleMiddle AgedPeptic Ulcer HemorrhageRisk AssessmentTime FactorsTime-to-Treatment

Identifiers

PMID32242355

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.