# Impact of Timing of Endoscopy on Mortality in Non-variceal Upper Gastrointestinal Bleeding: A Retrospective Cohort Study: -

## TL;DR

This study found no significant link between the timing of endoscopy and mortality in patients with non-variceal upper gastrointestinal bleeding.

## Contribution

The study contributes new evidence on the timing of endoscopy in non-variceal upper gastrointestinal bleeding mortality.

## Key findings

- No significant difference in mortality was found based on the timing of endoscopy.
- Diabetes was more common in patients who had endoscopy after 12 hours.
- Adjusting for diabetes did not show a significant association between endoscopy timing and mortality.

## Abstract

Non-variceal upper gastrointestinal bleeding is a common problem
worldwide, which is associated with a significant mortality rate. The
purpose of
this study was to investigate the relationship between the mortality rate of
patients referred to the emergency room with non-variceal upper
gastrointestinal
bleeding and the time of therapeutic-diagnostic endoscopy.

This study was a retrospective cohort observational study at Imam Reza
Hospital in Mashhad, which was conducted in patients presenting with obvious
symptoms of non-variceal acute gastrointestinal bleeding between April 2017
and
March 2018. Underlying variables, endoscopic history, hemoglobin level,
Glasgow
– Blatchford score, blood pressure and the endoscopic result were extracted
from
patients’ records. The time of death was followed up by telephone within 30
days
after hospitalization. Data were compared based on the time of endoscopy
since
arrival. Patients with gastrointestinal bleeding were initially evaluated in
the
emergency room, unstable patients were transferred to the emergency room for
stabilization and initial measures, and other patients were transferred to
the
emergency room, and the unstable patients were excluded from the plan.

In this study, 189 patients (with an average age of 60.11 ± 17.59 years)
were examined. 23 cases (12.16%) of death were recorded within 30 days. 26
people
(13.75%) underwent emergency endoscopy within 0 to 6 hours of referral.
Forty-four people (23.28%) underwent endoscopy within 6 to 12 hours and the
rest
(119 people, 62.96%) within 12 to 24 hours. There was no significant
difference
between deceased and recovered subjects in terms of various study variables,
including Blatchford score, number of days hospitalized in the ward and
intensive care unit, and the number of units of compressed red blood cells
injected (P0.05). Diabetes was significantly more prevalent in patients
undergoing endoscopy 12 h compared to the 12 h (3.36% vs. 32.86%; P=0.001).
adjusting for diabetes, the timing of endoscopy (within 12 hours vs. after
12
hours) was not significantly associated with mortality, with both crude (OR
1.25, 95% CI 0.63-2.49, P=0.523) and adjusted (OR 1.30, 95% CI 0.65-2.60,
P=0.456) odds ratios.

Our study showed no association between
endoscopy time and mortality in patients with upper gastrointestinal
bleeding;
however, this finding should be confirmed in future studies in more
controlled
populations as a clinical trial.