Document Type : Original Article
Authors
Department of Internal Medicine, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: This study was done to evaluate the relationship between the time of endoscopy in patients with upper gastrointestinal bleeding with morbidity and mortality rates of patients at the Al Zahra Hospital emergency room. Materials and Methods: In a cohort study, 1152 patients at 2014 and 2015 have been hospitalized due to gastrointestinal bleeding in Al Zahra Hospital, were selected and demographic and clinical information and day and time of endoscopy and hospital mortality and fewer deaths than a month after discharge were studied, and prognosis was analyzed in terms of day and time of endoscopy. Results: Nine hundred and seventy-three cases (84.5%) of endoscopy were performed during the working days and 179 (15.5%) were performed on holidays. Moreover, 801 cases (69.5%) of endoscopy were done in the morning and 351 cases (30.5%) were performed in the evening and night shifts. The day and time of endoscopy had no significant effect on mortality in hospital and less than a month after but hospital death in whom underwent endoscopy by fellowship was significantly higher (P = 0.004). Conclusion: Endoscopy in nonholiday and holiday days and the time of endoscopy has no significant effect on hospital mortality 1 month after discharge. However, other factors such as endoscopy by attendant or fellowship, time between admission to endoscopy, age and sex of the patients, etc., were significantly effective on in-hospital mortality and death 1 months after discharge. Also faster and sooner endoscopy cannot reduce rate of blood transfusions or reduce the length of hospital stay but faster endoscopy of patients can reduce the risk of in-hospital death.
Keywords
1. | |
2. |
Lin HJ, Wang K, Perng CL, Chua RT, Lee FY, Lee CH, et al. Early or delayed endoscopy for patients with peptic ulcer bleeding. A prospective randomized study. J Clin Gastroenterol 1996;22:267-71. [PUBMED] |
3. | |
4. |
Lee YC, Wang HP, Wu MS, Yang CS, Chang YT, Lin JT. Urgent bedside endoscopy for clinically significant upper gastrointestinal hemorrhage after admission to the intensive care unit. Intensive Care Med 2003;29:1723-8. [PUBMED] |
5. |
Spiegel BM, Vakil NB, Ofman JJ. Endoscopy for acute nonvariceal upper gastrointestinal tract hemorrhage: Is sooner better? A systematic review. Arch Intern Med 2001;161:1393-404. [PUBMED] |
6. |
Rockall TA, Logan RF, Devlin HB, Northfield TC. Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. Steering committee and members of the National Audit of acute upper gastrointestinal haemorrhage. BMJ 1995;311:222-6. [PUBMED] |
7. |
Laine L. Treatment of nonvariceal upper GI hemorrhage: What's happening in the real world. Am J Gastroenterol 2004;99:1247-9. [PUBMED] |
8. | |
9. | |
10. | |
11. | |
12. | |
13. | |
14. | |
15. | |
16. |