The impact of upper endoscopy in patients with upper gastrointestinal hemorrhage treated in community practice is unknown.
Thus we examined the effectiveness of endoscopy performed within 24 hours of admission (early endoscopy).
Medical records of 909 consecutive hospitalized patients with upper gastrointestinal hemorrhage who underwent endoscopy at 13 hospitals in a large metropolitan area were reviewed.
We evaluated unadjusted and severity-adjusted associations of early endoscopy with recurrent bleeding or surgery to control hemorrhage, length of hospital stay, and associations of endoscopic therapy in patients with bleeding ulcers or varices.
Early endoscopy was performed in 64% of patients and compared with delayed endoscopy and was associated with clinically significant reductions in adjusted risk of recurrent bleeding or surgery (odds ratio [OR] 0.70 : 95% Cl [0.44,1.13]) and a 31% decrease in adjusted length of stay (95% Cl : [24%, 37% ]). In patients at high risk for recurrent bleeding, the use of early endoscopic therapy to control hemorrhage was associated with reductions in recurrent bleeding or surgery (OR 0.21 : 95% Cl [0.10,0.47]) and length of stay (-31% : 95% Cl [-44%, - 14%). (...)
Mots-clés Pascal : Hémorragie, Gastrointestinal, Evaluation, Gastroscopie, Précoce, Facteur prédictif, Diminution, Hospitalisation, Récidive, Etude statistique, Homme, Appareil digestif pathologie, Estomac pathologie, Intestin pathologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Endoscopie
Mots-clés Pascal anglais : Hemorrhage, Gastrointestinal, Evaluation, Gastroscopy, Early, Predictive factor, Decrease, Hospitalization, Relapse, Statistical study, Human, Digestive diseases, Gastric disease, Intestinal disease, Cardiovascular disease, Vascular disease, Endoscopy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0153378
Code Inist : 002B24E06. Création : 16/11/1999.