Factors Predicting the Need for Endoscopic Intervention in Non-variceal Upper Gastrointestinal Bleeding

NCT05979025 | Completed

• 1 other identifier: AnkaraCHBilkent-NA-TEZ
• Study Type: observational
• Target: 262
• Locations: 1 country
• Sites: 1

Brief Summary

Gastrointestinal system bleedings are medical emergencies and the most common cause of hospital admissions related to digestive system diseases. Gastrointestinal system bleedings are a frequently encountered condition and one of the significant reasons leading to morbidity, mortality, and medical care costs. For acute upper gastrointestinal system bleedings, the annual hospital admission incidence in the United States is approximately 67 per 100,000 adults, making it more common than lower gastrointestinal system bleedings. Approximately 80% of acute upper gastrointestinal system bleedings are attributed to non-variceal causes. Endoscopy is an invasive procedure used for diagnosis and treatment in upper gastrointestinal system bleedings. . In recent years, there has been an increase in endoscopy and endoscopic treatment rates. Except for variceal bleedings, most upper gastrointestinal system bleedings stop without the need for endoscopic intervention. However, some patients require endoscopic intervention and identifying this high-risk group, prone to recurrent bleeding, through non-invasive tests is crucial. In investigators' prospective study, researcher aimed to facilitate the identification of patients who require intervention and undergo endoscopic intervention (e.g., epinephrine injection, hemoclips, thermal coagulation, argon plasma coagulation, etc.) among those who underwent endoscopy within the first 24 hours after admission to the hospital's emergency department with a diagnosis of non-variceal acute upper gastrointestinal system bleeding. Investigators sought to achieve this by determining the relevant parameters related to their clinical and laboratory findings, comorbidities, and demographic characteristics at the time of admission. This approach aims to reduce hospital admissions, hospital stay, and costs, and particularly to minimize interventional procedures during seizures and decrease complications.As of August 2022, patients who applied to the Ankara Bilkent City Hospital emergency department were followed up.

Conditions

Acute Upper Gastrointestinal Bleeding

Outcome Measures

Primary Outcomes (1)

• Endoscopic intervention

  Mechanical treatment (eg hemoclips, tape, etc.), injection therapy (eg epinephrine etc.), thermal coagulation (eg heater probe etc.)

  First 24 hours after hospital admission

Secondary Outcomes (3)

• İntensive care hospitalization

  30 days after admission to hospital

• Mortality

  30 days after admission to hospital

• Rebleeding

  30 days after admission to hospital

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients who are 18 years of age and older and present to our hospital with a diagnosis of non-variceal upper gastrointestinal bleeding, among whom endoscopy is performed within the first 24 hours after hospital admission

You may qualify if:

• Patients who present to our hospital with a diagnosis of non-variceal upper gastrointestinal bleeding
• Patients who undergo endoscopy within the first 24 hours after hospital admission

You may not qualify if:

• Patients who have variceal bleeding
• Lower gastrointestinal system bleeding
• Individuals who are under the age of 18
• Patients who do not undergo endoscopy within the first 24 hours after hospital admission

Sponsors & Collaborators

• Ankara City Hospital Bilkent: lead

Study Sites (1)

Ankara Bilkent City Hospital

Ankara, Turkey (Türkiye)

Location

Related Publications (9)

• Wuerth BA, Rockey DC. Changing Epidemiology of Upper Gastrointestinal Hemorrhage in the Last Decade: A Nationwide Analysis. Dig Dis Sci. 2018 May;63(5):1286-1293. doi: 10.1007/s10620-017-4882-6. Epub 2017 Dec 27.

  PMID: 29282637 RESULT

• Abougergi MS, Travis AC, Saltzman JR. The in-hospital mortality rate for upper GI hemorrhage has decreased over 2 decades in the United States: a nationwide analysis. Gastrointest Endosc. 2015 Apr;81(4):882-8.e1. doi: 10.1016/j.gie.2014.09.027. Epub 2014 Dec 5.

  PMID: 25484324 RESULT

• Masaoka T, Suzuki H, Hori S, Aikawa N, Hibi T. Blatchford scoring system is a useful scoring system for detecting patients with upper gastrointestinal bleeding who do not need endoscopic intervention. J Gastroenterol Hepatol. 2007 Sep;22(9):1404-8. doi: 10.1111/j.1440-1746.2006.04762.x.

  PMID: 17716345 RESULT

• Chen IC, Hung MS, Chiu TF, Chen JC, Hsiao CT. Risk scoring systems to predict need for clinical intervention for patients with nonvariceal upper gastrointestinal tract bleeding. Am J Emerg Med. 2007 Sep;25(7):774-9. doi: 10.1016/j.ajem.2006.12.024.

  PMID: 17870480 RESULT

• Lanas A, Dumonceau JM, Hunt RH, Fujishiro M, Scheiman JM, Gralnek IM, Campbell HE, Rostom A, Villanueva C, Sung JJY. Non-variceal upper gastrointestinal bleeding. Nat Rev Dis Primers. 2018 Apr 19;4:18020. doi: 10.1038/nrdp.2018.20.

  PMID: 29671413 RESULT

• Kamboj AK, Hoversten P, Leggett CL. Upper Gastrointestinal Bleeding: Etiologies and Management. Mayo Clin Proc. 2019 Apr;94(4):697-703. doi: 10.1016/j.mayocp.2019.01.022.

  PMID: 30947833 RESULT

• Wilkins T, Wheeler B, Carpenter M. Upper Gastrointestinal Bleeding in Adults: Evaluation and Management. Am Fam Physician. 2020 Mar 1;101(5):294-300.

  PMID: 32109037 RESULT

• Rockey DC. Gastrointestinal bleeding. Gastroenterol Clin North Am. 2005 Dec;34(4):581-8. doi: 10.1016/j.gtc.2005.08.002.

  PMID: 16303571 RESULT

• Lakatos L, Gonczi L, Lontai L, Izbeki F, Patai A, Racz I, Gasztonyi B, Varga-Szabo L, Ilias A, Lakatos PL. Incidence, Predictive Factors, Clinical Characteristics and Outcome of Non-variceal Upper Gastrointestinal Bleeding - A Prospective Population-based Study from Hungary. J Gastrointestin Liver Dis. 2021 Sep 21;30(3):327-333. doi: 10.15403/jgld-3495.

  PMID: 34375379 RESULT

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Medical Doctor

Study Record Dates

• First Submitted: July 30, 2023
• First Posted: August 7, 2023
• Study Start: August 11, 2022
• Primary Completion: July 29, 2023
• Study Completion: September 7, 2023
• Last Updated: February 16, 2024

Record last verified: 2024-02

Locations

TU (1)