Comparison of the Effectiveness of Interventional Endoscopy in Bleeding Peptic Ulcer Disease according to the Timing of Endoscopy
2
조회
0
다운로드
2
인용
0
참고문헌
초록
Background/Aims: The optimal timing for interventional endoscopy in bleeding peptic ulcer disease is controversial. This study compared the outcomes between early endoscopy and delayed endoscopy in patients with bleeding peptic ulcer disease. Methods: We conducted a prospective analysis of data from 90 patients with bleeding peptic ulcer disease who visited the emergency room between May 2006 and September 2007. Patients were categorized into two groups: the early-endoscopy group (admitted during the daytime or at night with prompt endoscopic management) and the delayed-endoscopy group (admitted at night or during weekends, with endoscopic management delayed until the next day). We compared the clinical outcomes of endoscopy between the two groups. Results: There were 49 patients in the early-endoscopy group and 41 patients in the delayed-endoscopy group. Patient demographics, clinical characteristics, bleeding control modality, and Rockall score did not differ between the two groups. There were also no significant differences between the early- and delayed-endoscopy groups in the re-bleeding rate (3/49 vs 5/41, p=0.313), the duration of hospital stay (10.7 vs 9.3 days, p=0.437), and the total amount of blood transfused (3.4 vs 2.7 units, p=0.240). Conclusions: The effectiveness of interventional endoscopy for patients with bleeding peptic ulcer disease is not significantly affected by the timing of endoscopy.
Abstract
Background/Aims: The optimal timing for interventional endoscopy in bleeding peptic ulcer disease is controversial. This study compared the outcomes between early endoscopy and delayed endoscopy in patients with bleeding peptic ulcer disease. Methods: We conducted a prospective analysis of data from 90 patients with bleeding peptic ulcer disease who visited the emergency room between May 2006 and September 2007. Patients were categorized into two groups: the early-endoscopy group (admitted during the daytime or at night with prompt endoscopic management) and the delayed-endoscopy group (admitted at night or during weekends, with endoscopic management delayed until the next day). We compared the clinical outcomes of endoscopy between the two groups. Results: There were 49 patients in the early-endoscopy group and 41 patients in the delayed-endoscopy group. Patient demographics, clinical characteristics, bleeding control modality, and Rockall score did not differ between the two groups. There were also no significant differences between the early- and delayed-endoscopy groups in the re-bleeding rate (3/49 vs 5/41, p=0.313), the duration of hospital stay (10.7 vs 9.3 days, p=0.437), and the total amount of blood transfused (3.4 vs 2.7 units, p=0.240). Conclusions: The effectiveness of interventional endoscopy for patients with bleeding peptic ulcer disease is not significantly affected by the timing of endoscopy.
참고문헌 (23)
- Rockall TA, "Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. in: Steering Committee and members of the National Audit of Acute Upper Gastrointestinal Haemorrhage", BMJ, 311, pp.222~226 (1995)
- Boonpongmanee S, "The frequency of peptic ulcer as a cause of upper-GI bleeding is exaggerated", Gastrointest Endosc, 59, pp.788~794 (2004)
- Laine L, "Bleeding peptic ulcer", N Engl J Med, 331, pp.717~727 (1994)
- Chung SC, "Peptic ulcer bleeding", Am J Gastroenterol, 96, pp.1~3 (2001)
- Sacks HS, "Endoscopic hemostasis. in: An effective therapy for bleeding peptic ulcers", JAMA, 264, pp.494~499 (1990)
- Cook DJ, "Endoscopic therapy for acute nonvariceal upper gastrointestinal hemorrhage: a meta-analysis", Gastroenterology, 102, pp.139~148 (1992)
- Laine L, "Prospective evaluation of immediate versus delayed refeeding and prognostic value of endoscopy in patients with upper gastrointestinal hemorrhage", Gastroenterology, 102, pp.314~316 (1992)
- Lau JY, "The evolution of stigmata of hemorrhage in bleeding peptic ulcers: a sequential endoscopic study", Endoscopy, 30, pp.513~518 (1998)
- Cooper GS, "Early endoscopy in upper gastrointestinal hemorrhage: associations with recurrent bleeding, surgery, and length of hospital stay", Gastrointest Endosc, 49, pp.145~152 (1999)
- Tai CM, "High-risk ED patients with nonvariceal upper gastrointestinal hemorrhage undergoing emergency or urgent endoscopy: a retrospective analysis", Am J Emerg Med, 25, pp.273~278 (2007)
- Blocksom JM, "Current therapy for nonvariceal upper gastrointestinal bleeding", Surg Endosc, 18, pp.186~192 (2004)
- Rockall TA, "Risk assessment after acute upper gastrointestinal haemorrhage", Gut, 38, pp.316~321 (1996)
- Spiegel BM, "Endoscopy for acute nonvariceal upper gastrointestinal tract hemorrhage: is sooner better?. in: A systematic review", Arch Intern Med, 161, pp.1393~1404 (2001)
- Schacher GM, "Is early endoscopy in the emergency room beneficial in patients with bleeding peptic ulcer?. in: A "fortuitously controlled" study", Endoscopy, 37, pp.324~328 (2005)
- Lin HJ, "Early or delayed endoscopy for patients with peptic ulcer bleeding. in: A prospective randomized study", J Clin Gastroenterol, 22, pp.267~271 (1996)
- Yen D, "Arterial oxygen desaturation during emergent nonsedated upper gastrointestinal endoscopy in the emergency department", Am J Emerg Med, 15, pp.644~647 (1997)
- Hill DB, "Arterial oxygen saturation during emergency esophagogastroduodenoscopy. in: The effects of nasal oxygen", J Clin Gastroenterol, 18, pp.284~286 (1994)
- Barkun A, "Consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding", Ann Intern Med, 139, pp.843~857 (2003)
- Hay JA, "Prospective evaluation of a clinical guideline recommending hospital length of stay in upper gastrointestinal tract hemorrhage", JAMA, 278, pp.2151~2156 (1997)
- Cooper GS, "The effectiveness of early endoscopy for upper gastrointestinal hemorrhage: a community-based analysis", Med Care, 36, pp.462~474 (1998)
- Erstad BL, "Proton-pump inhibitors for acute peptic ulcer bleeding", Ann Pharmacother, 35, pp.730~740 (2001)
- Andriulli A, "Proton-pump inhibitors and outcome of endoscopic hemostasis in bleeding peptic ulcers: a series of meta-analyses", Am J Gastroenterol, 100, pp.207~219 (2005)
- Leontiadis GI, "Proton pump inhibitor treatment for acute peptic ulcer bleeding", Cochrane Database Syst Rev, 25, pp.CD002094~ (2006)