Evidence map›Paper›PMID 39962393›Full record

ArticleBMC gastroenterology2025

Impact of duration to endoscopy in patients with non-variceal upper gastrointestinal bleeding: propensity score matching analysis of real-world data from Thailand.

Arunchai Chang, Natthawat Sitthinamsuwan, Nuttanit Pungpipattrakul, Kittiphan Chienwichai, Keerati Akarapatima, Sorawat Sangkaew, Manus Rugivarodom, Attapon Rattanasupar, Bancha Ovartlarnporn, Varayu Prachayakul

Abstract read
In one paragraph

Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Arunchai ChangDivision of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand.
Natthawat SitthinamsuwanDepartment of Internal Medicine, Hatyai Hospital, Songkhla, Thailand.
Nuttanit PungpipattrakulDivision of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand.
Kittiphan ChienwichaiDepartment of Internal Medicine, Hatyai Hospital, Songkhla, Thailand.
Keerati AkarapatimaDivision of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand.
Sorawat SangkaewDepartment of Social Medicine, Hatyai Hospital, Songkhla, Thailand.
Manus RugivarodomSiriraj Gastrointestinal Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Attapon RattanasuparDivision of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand.
Bancha OvartlarnpornNKC Institute of Gastroenterology and Hepatology, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Songkhla, Thailand.
Varayu PrachayakulSiriraj Gastrointestinal Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. kaiyjr@gmail.com.ORCID http://orcid.org/0000-0001-6652-9044

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe findings on mortality, rebleeding rate, and hospital stay in patients who underwent early vs. late endoscopy are conflicting. We aimed to compare in-hospital outcomes and medical resource use in patients with acute non-variceal upper gastrointestinal bleeding.

methodsWe retrospectively reviewed the medical records of patients with acute non-variceal upper gastrointestinal bleeding who underwent early or late endoscopy between 2016 and 2019. The primary outcome was in-hospital mortality. The secondary outcomes were the need for packed red blood cells and number of transfusions, the proportion of lesions with high-risk stigmata, endoscopic and additional hemostasis, in-hospital rebleeding, duration of stay, and admission cost. Statistical analysis was performed using Pearson's chi-squared or Fisher's exact test for categorical variables, Student's t-test, and Wilcoxon rank-sum test for continuous variables.

resultsEarly and late endoscopies were performed on 451 and 279 patients, respectively. After 1:1 propensity score matching, 278 patients from each group were included, and patients' baseline characteristics were similar in the matched groups. Compared with the late group, the early group had a significantly increased rate of endoscopic hemostasis (22.7% vs. 13.7%, P = 0.006) and a low rate of packed red blood cell transfusion (53.6% vs. 61.9%, P = 0.048). Duration of stay and admission costs were significantly higher in the late group than in the early group (all P < 0.05). After adjusting for confounding factors, early endoscopy was positively associated with ulcers with high-risk stigmata (adjusted odds ratio = 1.83, P = 0.023) and endoscopic hemostasis (adjusted odds ratio = 1.97, P = 0.004). It was negatively associated with the need for packed red blood cell transfusion (adjusted odds ratio = 0.62, P = 0.017) and duration of stay (adjusted coefficient=-0.10, P < 0.001) with no impact on in-hospital mortality, rebleeding, or radiological interventions.

conclusionsThe timing of endoscopy does not affect in-hospital mortality or rebleeding rate. This study supports using early endoscopy in patients with acute non-variceal upper gastrointestinal bleeding based on the potential benefits and feasibility of medical resource use.

Indexed as

Endoscopy, GastrointestinalGastrointestinal HemorrhageHemostasis, EndoscopicTime-to-TreatmentAgedBlood TransfusionErythrocyte TransfusionFemaleHospital MortalityHumansLength of StayMaleMiddle AgedPropensity ScoreRecurrenceRetrospective StudiesClinical outcomesEarly endoscopyMedical resource useNon-variceal upper gastrointestinal bleedingTime to endoscopy

Identifiers

PMID39962393
PMCPMC11834220

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.