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Current guidelines recommend early endoscopy, performed within 24 hours, for patients with acute nonvariceal upper gastrointestinal bleeding (UGIB). However, there is controversy over whether urgent endoscopy, performed within 6 to 12 hours, benefits those patients at high risk for further bleeding or death.
To address this issue, investigators in Hong Kong randomized 516 patients with a Glasgow-Blatchford score ≥12 (i.e., high-risk) to undergo urgent endoscopy within 6 hours or early endoscopy within 24 hours of GI consultation. The mean actual time to endoscopy after initial presentation was 10 hours in the urgent endoscopy group and 25 hours in the early endoscopy group. Outcomes were similar in the two respective groups, as follows:
Endos…