The Value of Timing for Esophagogastroduodenoscopy in Assessing Prognosisof High-Risk Acute Upper Gastrointestinal BleedingLintianjiao

LIN Tianqiao

doi:10.13919/j.issn.2095-6274.ZHJY202408011

Abstract：Objective To compare the clinical value of performing endoscopy at different time intervals for patients with acute upper gastrointestinal bleeding.Methods A retrospective review of clinical data was per-formed on 60 patients who were treated for acute upper gastrointestinal bleeding at Xianyou County Maternity and Child Health Hospital from January 2022 to January 2024.Based on the timing of endoscopic examination after ad-mission,the patients were divided into three groups:the routine group(24-48 hours,n=20),the early group(8-24 hours,n=20),and the ultra-early group(within 8 hours,n=20).The groups were compared in terms of endoscopic findings,blood loss,hospital stay duration and costs,and laboratory indices.Results There was no significant difference in the positive rate of gastroscopy among the three groups of patients with acute upper gastrointestinal bleeding(P＞0.05).Both the ultra-early and early groups had significantly higher detection rates of active bleeding compared to the conventional group(P＜0.05),while there was no significant difference between the ultra-early and early groups in terms of active bleeding detection rates(P＞0.05).The rates of rebleeding after hemostasis in the ultra-early and early groups were significantly lower than in the conventional group(P＜0.05),with no significant difference in the active bleeding detection rates between the ultra-early and early groups(P＞0.05).The volume of bleeding in the ultra-early and early groups was significantly lower than in the conventional group(P＜0.001),and the bleeding volume in the ultra-early group was significantly lower than in the early group(P＜0.05).The hospital-ization duration in both the ultra-early and early groups was significantly shorter than in the conventional group,and the bleeding volume in the ultra-early group was significantly lower than in the early group(P＜0.001).Hospitalization costs in the ultra-early and early groups were significantly lower than in the conventional group(P＜0.001),with the ultra-early group also having signif-icantly lower costs than the early group(P＜0.001).One week later,the hemoglobin level in the ultra-early group was significantly higher than in the early and conventional groups(P＜0.05),while serum albumin and neutrophil percentage were significantly lower than in the early and conventional groups(P＜0.05).There was no significant difference in hemoglobin levels between the early and conventional groups(P＞0.05).Conclusion For patients with acute upper gastrointestinal bleeding,early endoscopic examination significantly improves the detection rate of active bleeding sites,facilitates timely therapeutic intervention,reduces blood loss,lowers the risk of rebleeding,and shortens hospital stay.