Relationships of hospitalization outcomes and timing to endoscopy in non-variceal upper gastrointestinal bleeding:A nationwide analysis  

作　　者：Simcha Weissman Muhammad Aziz Ayrton I Bangolo Dean Ehrlich Arnold Forlemu Anthony Willie Manesh K Gangwani Danish Waqar Hannah Terefe Amritpal Singh Diego MC Gonzalez Jayadev Sajja Fatma L Emiroglu Nicholas Dinko Ahmed Mohamed Mark A Fallorina David Kosoy Ankita Shenoy Anvit Nanavati Joseph D Feuerstein James H Tabibian 

机构地区：[1]Department of Internal Medicine,Palisades Medical Center,North Bergen,NJ 07047,United States [2]Department of Gastroenterology,University of Toledo Medical Center,Toledo,OH 43614,United States [3]Division of Digestive Diseases,David Geffen School of Medicine at University of California at Los Angeles,Los Angeles,CA 90095,United States [4]Department of Internal Medicine,Creighton University School of Medicine,Phoenix,AZ 85012,United States [5]Division of Gastroenterology,Beth Israel Deaconess Medical Center,Harvard Medical School,Boston,MA 02215,United States [6]Division of Gastroenterology,Department of Medicine,Olive View-University of California at Los Angeles Medical Center,Sylmar,CA 91342,United States

出　　处：《World Journal of Gastrointestinal Endoscopy》2023年第4期285-296,共12页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND The optimal timing of esophagogastroduodenoscopy(EGD)and the impact of clinico-demographic factors on hospitalization outcomes in non-variceal upper gastrointestinal bleeding(NVUGIB)remains an area of active research.AIM To identify independent predictors of outcomes in patients with NVUGIB,with a particular focus on EGD timing,anticoagulation(AC)status,and demographic features.METHODS A retrospective analysis of adult patients with NVUGIB from 2009 to 2014 was performed using validated ICD-9 codes from the National Inpatient Sample database.Patients were stratified by EGD timing relative to hospital admission(≤24 h,24-48 h,48-72 h,and>72 h)and then by AC status(yes/no).The primary outcome was all-cause inpatient mortality.Secondary outcomes included healthcare usage.RESULTS Of the 1082516 patients admitted for NVUGIB,553186(51.1%)underwent EGD.The mean time to EGD was 52.8 h.Early(<24 h from admission)EGD was associated with significantly decreased mortality,less frequent intensive care unit admission,shorter length of hospital stays,lower hospital costs,and an increased likelihood of discharge to home(all with P<0.001).AC status was not associated with mortality among patients who underwent early EGD(aOR 0.88,P=0.193).Male sex(OR 1.30)and Hispanic(OR 1.10)or Asian(aOR 1.38)race were also independent predictors of adverse hospitalization outcomes in NVUGIB.CONCLUSION Based on this large,nationwide study,early EGD in NVUGIB is associated with lower mortality and decreased healthcare usage,irrespective of AC status.These findings may help guide clinical management and would benefit from prospective validation.

关 键 词：Upper gastrointestinal bleeding ESOPHAGOGASTRODUODENOSCOPY OUTCOMES Mortality ANTICOAGULATION 

分 类 号：R573.2[医药卫生—消化系统]