ROME — It is widely accepted that urgent endoscopy for upper gastrointestinal bleeding (UGIB) should be performed within 24 hour from the admission. However, within this period of time, it is still unclear whether it should be performed either very early (within two hours) or in a more delayed interval, such as after six, 12 or 24 hours. Therefore, optimal timing for urgent endoscopy in UGIB patients has not been yet established.
A research article published in the August 28 issue of World Journal of Gastroenterology addresses this question. The research assessed whether a simplified clinical score prior to endoscopy in UGIB patients was able to predict either active bleeding or endoscopic signs of recent haemorrhage which may deserve an urgent (< 2 h) endoscopy.
When classifying 436 patients according to this score (T-score), active bleeding or signs of recent hemorrhage was detected in 85 percent of T1 (most severe) patients and only in 5 percent and 2 percent of those T2/T3 (less severe), respectively.
This study shows that timing of urgent endoscopy following an episode of UGIB may be differentiated according to a simple score purely reflecting the clinical conditions of the patients. This would allow most of the high-risk patients to be effectively treated, whilst delaying most of the purely diagnostic procedures in low risk clinical patients, according to the article. A future, randomized study is required to validate this clinical score.