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Panminerva Medica 2020 May 20

DOI: 10.23736/S0031-0808.20.03960-9


language: English

Predictors of endoscopic intervention in upper gastrointestinal bleeding patients hospitalized for another illness: a multi-center retrospective study

Tawfik KHOURY 1, 2, Fares DARAWSHEH 3, Saleh DAHER 4, Shaul YAARI 4, Lior KATZ 4, Mahmud MAHAMID 5, Anas KADAH 1, 2, Amir MARI 2, 6 , Wisam SBEIT 1, 2

1 Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel; 2 Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel; 3 Department of Internal Medicine, Hadassah Medical Center, Jerusalem, Israel; 4 Department of Gastroenterology, Hadassah Medical Center, Jerusalem, Israel; 5 Department of Gastroenterology, Sharee Zedek Medical Center, Jerusalem, Israel; 6 Gastroenterology and Edoscopy Unit, The Nazareth Hospital, EMMS, Nazareth, Israel


BACKGROUND: To characterize variables that may predict the need for endoscopic intervention in inpatients admitted for several causes who during the hospitalization developed acute non-variceal upper gastrointestinal bleeding (NVUGIB).
METHODS: A retrospective analysis of inpatients who underwent upper GI endoscopy for acute NVUGIB while hospitalized for other causes from 1st January 2016 till 1st December 2017, was performed. In the primary outcome analysis, patients (n: 14) who underwent endoscopic intervention (group A) were compared to those (n: 87) who did not need for endoscopic intervention (group B). Secondary outcome analysis included patients who had significant endoscopic findings compared to those who did not have them.
RESULTS: Multivariate regression analysis showed that in the primary outcome analysis, two parameters were significant: the number of packed red blood cells (PRBC) units transfused (Odds Ratio [OR]:1.5, P=0.01) and Rockall score (RS) (OR: 1.4, P=0.06) with receiver operator characteristic (ROC) curve of 0.7844. In the secondary outcome analysis, only the use of proton pump inhibitor (PPI) drugs at admission was associated with protective effect for the development of significant endoscopic findings (OR: 0.42, P=0.05) with ROC curve of 0.7342.
CONCLUSIONS: In hospitalized patients, in case of de novo NVUGIB, the number of PRBC units transfused and RS are predictive of significant endoscopic findings.

KEY WORDS: Upper GI bleeding; Endoscopic; Intervention; Predictors

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