The influence of endoscopy timing on clinical and cost-effectiveness outcomes in acute upper gastrointestinal bleeding patients
WU Na
HU Jun
WEN Cai
CHEN Hui
WU Hao
LI Li
YU Tao
Abstract：Objective To analyze the clinical effectiveness and cost-effectiveness of different endoscopy timing in patients with acute upper gastrointestinal bleeding(AUGIB).Methods The patients with AUGIB presented in the emergency department of Sun Yat-Sen Memorial Hospital from January 2022 to December 2023 who received endoscopy within 48 hours were studied retrospectively and were classified based on endoscopic timing postadmission:urgent(t≤12h),early(12 h＜t≤24 h)and routine(24 h＜t≤48 h).According to the patient's clinical data,the inverse probability of treatment weighting(IPTW)was used to balance the baseline characteristics of the three groups,the treatment effect of the three groups were compared,and the cost-effectiveness of endoscopy was analyzed.Results A total of 282 AUGIB patients were included,including 102 in the urgent endoscopy group,136 in the early endoscopy group and 44 in the routine endoscopy group.After IPTW adjustment,the baseline data of age,sex,past medical history of digestive system disease,and severity of initial disease in the three groups were balanced(All P＞0.05).By univariate analysis,there was no statistical difference in the rate of hemostasis,ICU admission and all-cause mortality during hospitalization in three groups(All P＞0.05),the proportion of blood transfusion,volume of blood transfused,emergency observation time,and medical costs in the urgent endoscopy group were all significantly lower than those in the early endoscopy group and the routine endoscopy group(All P＜0.05).Conclusion Compared with early and routine endoscopy,urgent endoscopy can shorten emergency observation time and reduce medical cost and blood transfusion volume,which shows significant advantages in improving the efficiency of medical service and reducing the cost of medical treatment for patients.
Keywords：acute upper gastrointestinal bleedingtiming of endoscopyeconomic benefits
Publication Date：2024-09-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 770-775 )