Impact of duration to endoscopy in patients with non-variceal upper gastrointestinal bleeding: propensity score matching analysis of real-world data from Thailand
Issued Date
2025-12-01
Resource Type
eISSN
1471230X
Scopus ID
2-s2.0-85218503234
Journal Title
BMC Gastroenterology
Volume
25
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMC Gastroenterology Vol.25 No.1 (2025)
Suggested Citation
Chang A., Sitthinamsuwan N., Pungpipattrakul N., Chienwichai K., Akarapatima K., Sangkaew S., Rugivarodom M., Rattanasupar A., Ovartlarnporn B., Prachayakul V. Impact of duration to endoscopy in patients with non-variceal upper gastrointestinal bleeding: propensity score matching analysis of real-world data from Thailand. BMC Gastroenterology Vol.25 No.1 (2025). doi:10.1186/s12876-025-03673-w Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/105492
Title
Impact of duration to endoscopy in patients with non-variceal upper gastrointestinal bleeding: propensity score matching analysis of real-world data from Thailand
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Corresponding Author(s)
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Abstract
Background: The findings on mortality, rebleeding rate, and hospital stay in patients who underwent early vs. late endoscopy are conflicting. We aimed to compare in-hospital outcomes and medical resource use in patients with acute non-variceal upper gastrointestinal bleeding. Methods: We retrospectively reviewed the medical records of patients with acute non-variceal upper gastrointestinal bleeding who underwent early or late endoscopy between 2016 and 2019. The primary outcome was in-hospital mortality. The secondary outcomes were the need for packed red blood cells and number of transfusions, the proportion of lesions with high-risk stigmata, endoscopic and additional hemostasis, in-hospital rebleeding, duration of stay, and admission cost. Statistical analysis was performed using Pearson’s chi-squared or Fisher’s exact test for categorical variables, Student’s t-test, and Wilcoxon rank-sum test for continuous variables. Results: Early and late endoscopies were performed on 451 and 279 patients, respectively. After 1:1 propensity score matching, 278 patients from each group were included, and patients’ baseline characteristics were similar in the matched groups. Compared with the late group, the early group had a significantly increased rate of endoscopic hemostasis (22.7% vs. 13.7%, P = 0.006) and a low rate of packed red blood cell transfusion (53.6% vs. 61.9%, P = 0.048). Duration of stay and admission costs were significantly higher in the late group than in the early group (all P < 0.05). After adjusting for confounding factors, early endoscopy was positively associated with ulcers with high-risk stigmata (adjusted odds ratio = 1.83, P = 0.023) and endoscopic hemostasis (adjusted odds ratio = 1.97, P = 0.004). It was negatively associated with the need for packed red blood cell transfusion (adjusted odds ratio = 0.62, P = 0.017) and duration of stay (adjusted coefficient=-0.10, P < 0.001) with no impact on in-hospital mortality, rebleeding, or radiological interventions. Conclusions: The timing of endoscopy does not affect in-hospital mortality or rebleeding rate. This study supports using early endoscopy in patients with acute non-variceal upper gastrointestinal bleeding based on the potential benefits and feasibility of medical resource use.