ArticleIrish journal of medical science2026
Timing of endoscopy and its impact on prognosis in patients admitted to the emergency department with upper gastrointestinal bleeding.
Article in Irish journal of medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundAcute 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.
aimsThis 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.
methodsIn 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.
resultsA 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.
conclusionEndoscopy 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.
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