Routine early endoscopy in upper-gastrointestinal-tract bleeding: a randomized, controlled trial

The New England Journal of Medicine
W L PetersonD B Corbett

Abstract

To determine whether routine early endoscopy is beneficial to patients with upper-gastrointestinal-tract bleeding that ceases during hospitalization, we randomly assigned 206 patients to routine endoscopy (100 patients) or no routine endoscopy (106). Patients in the latter group underwent endoscopy only if recurrent bleeding occurred during hospitalization or if x-ray films disclosed gastric ulcer or suggested neoplasia. All patients were initially treated with an empiric antacid regimen. When the two groups were compared (experimental versus control), there were no significant differences in overall hospital deaths (11 versus eight), recurrence of bleeding (33 versus 32), number of transfusions required to treat recurrent bleeding (mean +/- S.E.M., 7.4 +/- 1.2 versus 6.3 +/- 0.7 units), deaths after recurrent bleeding (eight versus five), or duration of hospital stay. During the 12 months after discharge, there were also no significant differences in frequency of readmission to the hospital, incidence of further gastrointestinal bleeding, number of hemorrhage-related deaths, or frequency of gastrointestinal surgery. We conclude that endoscopy should not be a routine procedure in patients with upper-gastrointestinal-tract bleed...Continue Reading

Citations

Nov 1, 1983·World Journal of Surgery·C P Swain
Nov 7, 2008·European Radiology·Hyun Joo LeeKyu-Bo Sung
Jan 1, 1985·Journal of Chronic Diseases·H O Conn, T Poynard
Jan 28, 2004·Gastrointestinal Endoscopy·Felix W Leung
Jul 2, 2004·Gastrointestinal Endoscopy·David J BjorkmanGinger Guest-Warnick
Nov 1, 1983·Gastrointestinal Endoscopy·K ShivshankerR S Nelson
Nov 1, 1986·Mayo Clinic Proceedings·T F ManganA R Zinsmeister
Jun 3, 2000·Gastroenterology Clinics of North America·H HussainM S Cappell
Jun 3, 2000·Gastroenterology Clinics of North America·T J Savides, D M Jensen
Sep 30, 2006·Nature Clinical Practice. Gastroenterology & Hepatology·John G Lee
Apr 8, 1982·The New England Journal of Medicine
Sep 15, 1983·The New England Journal of Medicine·M L Steer, W Silen
Mar 1, 1984·The New England Journal of Medicine·D B Reuben
Sep 15, 1994·The New England Journal of Medicine·L Laine, W L Peterson
Aug 15, 1981·British Medical Journal
Feb 20, 1982·British Medical Journal·A E Young
Jun 1, 1982·Postgraduate Medical Journal·H Ellis
Feb 1, 1991·Postgraduate Medical Journal·A E Gimson, D Westaby
Apr 3, 2012·World Journal of Gastroenterology : WJG·Ingrid Lisanne Holster, Ernst Johan Kuipers
Nov 26, 2013·Clinics and Research in Hepatology and Gastroenterology·Jérôme RivoryJérôme Dumortier
Sep 5, 2014·Digestive Diseases and Sciences·C Mel Wilcox
Mar 1, 1987·The American Journal of Medicine·R I Horwitz
Mar 1, 1986·The American Journal of Emergency Medicine·H K Gogel, D Tandberg
Mar 14, 2017·The Korean Journal of Internal Medicine·Jee Hyun KimJoo Sung Kim
Apr 2, 1999·Emergency Medicine Clinics of North America·D J Peter, J M Dougherty
Jan 8, 2004·Emergency Medicine Clinics of North America·Nahid HamouiPeter F Crookes
Aug 1, 1996·Emergency Medicine Clinics of North America·T D McGuirk, W J Coyle
Jul 28, 2009·Gastrointestinal Endoscopy·Brennan M R Spiegel
Mar 1, 1989·The British Journal of Surgery·R J Steele
Jan 1, 1984·Lasers in Surgery and Medicine·S N JoffeS S Rao
Nov 1, 1984·The British Journal of Surgery·R M KernohanT L Kennedy
Oct 1, 1987·The British Journal of Surgery·S BrearleyM R Keighley
Nov 11, 2005·The American Journal of Gastroenterology·Dennis M Jensen
Oct 1, 1987·Journal of Surgical Oncology·R Moreno-OteroJ M Pajares
Jan 1, 1985·Scandinavian Journal of Gastroenterology·P Wara, H Stødkilde
Jan 21, 1988·The New England Journal of Medicine
Feb 1, 1985·Gastroenterologia Japonica·K HajiroT Yamamoto
May 1, 1986·Scandinavian Journal of Gastroenterology·U FjøsneH Petersen

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