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PTH-037 Timing of endoscopy in acute upper gastrointestinal bleeding (augib). are we jumping the gun?
  1. J Schembri1,
  2. M Thoufeeq
  1. Department of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK

Abstract

Introduction AUGIB is a common medical emergency with a mortality rate that has only improved modestly over recent years. Current guidelines advise early endoscopy within 24 hours for all cases of nonvariceal AUGIB and several studies have looked at the role of very early endoscopy as an effort to improve outcomes.

Method We conducted a retrospective review of all AUGIB cases who underwent endoscopy at Sheffield teaching hospitals over a 1 year period (Apr 2015-Mar 2016). Time to endoscopy was calculated from admission (or referral in the case of inpatients) and patients with a pre-endoscopy Rockall≥4 were categorised as high risk.

Results A total of 444 urgent endoscopies for suspected AUGIB were performed. Mean age was 66.6 years (95% CI±1.8). 47.3%(n=210) of procedures were on inpatients, 35.1%(n=156) had a negative endoscopy and 28.2%(n=125) required endotherapy. Overall 30 day mortality rate was 11.7%(n=47).

Timing of endoscopy did not influence outcomes including need for further intervention, rebleeding rates or mortality. However patients who underwent endoscopy within 24 hours were more likely to require a blood transfusion (Table 1).

Conclusion The higher need for transfusion in patients who underwent early endoscopy reflects the lower Haemoglobin levels in this group. Whether the severity of the anaemia impacted on the timing of endoscopy is difficult to determine from this retrospective study. From our experience unless urgent endotherapy is required for haemostasis of active bleeding, timing of endoscopy in AUGIB has little impact on patient outcomes.

Disclosure of Interest None Declared

Abstract PTH-037 Table 1

AUGIB outcomes based on time to first endoscopy

  • Acute Upper Gastrointestinal Bleeding
  • mortality

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