ArticleBMC gastroenterology2024
Optimal endoscopy timing in elderly patients presenting with acute non-variceal upper gastrointestinal bleeding.
Article in BMC gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Article
- Minutes to Save a Life in Acute GI Bleeding: A Systematic Review of Early vs. Delayed Endoscopy.Cureus · 2025Review
- Are Scoring Systems Useful in Predicting Mortality from Upper GI Bleeding in Geriatric Patients?Diagnostics (Basel, Switzerland) · 2025Article
- Analysis of factors associated with 1-year rebleeding in patients with acute upper gastrointestinal bleeding and a Glasgow- Blatchford Score ≥ 6 based on serological indicators.Frontiers in medicine · 2025Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo evaluate the optimal endoscopy time in elderly patients with nonvariceal upper gastrointestinal bleeding (NVUGIB) based on clinical outcomes.
methodsPatients over 65 years of age presenting with NVUGIB are three patient groups based on endoscopy timing: very early endoscopy (< 12 h), early endoscopy (12-24 h) and late endoscopy (> 24 h). Endoscopic intervention was undertaken during the first 12 h for patients who had unstable hemodynamic settings, ongoing bleeding, or a low hematocrit despite transfusion. The clinical outcomes investigated were: The primary endpoint was 30-day mortality, with the need for endoscopic intervention, rebleeding, and length of hospital stay considered as secondary endpoints.
resultsThe study population was 468, 260 of whom were ≥ 65 years. Based on the timing of endoscopy, very early endoscopy (within 12 h) was performed in 180 (69.2%) patients aged > 65 years and 150 (72.1%) younger patients (p > 0.05). Early endoscopy (12-24 h) was performed in patients aged > 65 years and younger patients 53 (20.4%) vs. 41 (19.7%), respectively, while late endoscopy (24-48 h) was performed in 27 (10.4%) vs. 17 (8.2%) patients, respectively (p > 0.05, for all parameters). The clinical results of subgroups based on endoscopy time in the ≥ 65 population and comparisons between groups. When groups were compared, it was found that the very early endoscopy group had a considerably lower likelihood of need for surgical/radiological intervention than the late endoscopy group [3 (1,7) vs. (3,7), p = 0.016], and 30-day mortality rates by the endoscopy timing were statistically significantly different in the very early group (15.6%), early endoscopy group (7.5%), and late endoscopy group (29.6%) (p < 0.05, for all groups). Endoscopy time within 24-48 h (late) (OR: 3.133, 95%Cl: 1.127-8.713, p: 0.029) was an independent predictor of rebleeding during the hospital stay.
conclusionsEarly endoscopy may benefit the management of acute UGIB, especially in the elderly population with high comorbidities and the severity of bleeding.
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