Early Endoscopy in Acute Upper GI Bleeding Is Associated with Lower Mortality

Guidelines recommend early esophagogastroduodenoscopy (EGD; within 24–48 hours) for patients with acute upper gastrointestinal bleeding (UGIB). However, data are conflicting on the association of early EGD with better (or worse) clinical outcomes. To clarify this issue, investigators retrospectively reviewed the hospitalizations of approximately 1.8 million U.S. patients with a diagnosis of UGIB. They assessed the effect of timing of EGD (within 24 hours [49%], later than 24 hours [35%], or not at all [16%]) on mortality, length of hospital stay, and hospitalization cost.

In multivariable analysis, not undergoing an EGD was associated with increased risk for in-hospital death compared with undergoing early EGD (odds ratio, 3.0) or late EGD (…