Cargando…

Defining Time in Acute Upper Gastrointestinal Bleeding: When Should We Start the Clock?

Introduction: The execution of upper endoscopy at the proper time is key to correctly managing patients with upper gastrointestinal bleeding (UGIB). Nonetheless, the definition of “time” for endoscopic examinations in UGIB patients is imprecise. The primary aim of this study was to verify whether th...

Descripción completa

Detalles Bibliográficos
Autores principales: Marmo, Riccardo, Soncini, Marco, Bucci, Cristina, Marmo, Clelia, Riccioni, Maria Elena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10094998/
https://www.ncbi.nlm.nih.gov/pubmed/37048626
http://dx.doi.org/10.3390/jcm12072542
_version_ 1785023975462535168
author Marmo, Riccardo
Soncini, Marco
Bucci, Cristina
Marmo, Clelia
Riccioni, Maria Elena
author_facet Marmo, Riccardo
Soncini, Marco
Bucci, Cristina
Marmo, Clelia
Riccioni, Maria Elena
author_sort Marmo, Riccardo
collection PubMed
description Introduction: The execution of upper endoscopy at the proper time is key to correctly managing patients with upper gastrointestinal bleeding (UGIB). Nonetheless, the definition of “time” for endoscopic examinations in UGIB patients is imprecise. The primary aim of this study was to verify whether the different definitions of “time” (i.e., the symptoms-to-endoscopy and presentation-to-endoscopy timeframes) impact mortality. The secondary purpose of this study was to evaluate the similarity between the two timeframes. Methods: A post-hoc analysis was performed on a prospective multicenter cohort study, which included UGIB patients admitted to 50 Italian hospitals. We collected the timings from symptoms and presentation to endoscopy, together with other demographic, organizational and clinical data and outcomes. Results: Out of the 3324 patients in the cohort, complete time data were available for 3166 patients. A significant difference of 9.2 h (p < 0.001) was found between the symptoms-to-endoscopy vs. presentation-to-endoscopy timeframes. The symptoms-to-endoscopy timeframe demonstrated (1) a different death risk profile and (2) a statistically significant improvement in the prediction of mortality risk compared to the presentation-to-endoscopy timeframe (p < 0.0002). The similarity between the two different timeframes was moderate (K = 0.42 ± 0.01; p < 0.001). Conclusions: The symptoms-to-endoscopy and presentation-to-endoscopy timeframes referred to different timings during the management of upper endoscopy in bleeding patients, with the former being more accurate in correctly identifying the mortality risk of these patients. We suggest that further studies be conducted to validate our observations, and, if confirmed, a different definition of time should be adopted in endoscopy.
format Online
Article
Text
id pubmed-10094998
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-100949982023-04-13 Defining Time in Acute Upper Gastrointestinal Bleeding: When Should We Start the Clock? Marmo, Riccardo Soncini, Marco Bucci, Cristina Marmo, Clelia Riccioni, Maria Elena J Clin Med Article Introduction: The execution of upper endoscopy at the proper time is key to correctly managing patients with upper gastrointestinal bleeding (UGIB). Nonetheless, the definition of “time” for endoscopic examinations in UGIB patients is imprecise. The primary aim of this study was to verify whether the different definitions of “time” (i.e., the symptoms-to-endoscopy and presentation-to-endoscopy timeframes) impact mortality. The secondary purpose of this study was to evaluate the similarity between the two timeframes. Methods: A post-hoc analysis was performed on a prospective multicenter cohort study, which included UGIB patients admitted to 50 Italian hospitals. We collected the timings from symptoms and presentation to endoscopy, together with other demographic, organizational and clinical data and outcomes. Results: Out of the 3324 patients in the cohort, complete time data were available for 3166 patients. A significant difference of 9.2 h (p < 0.001) was found between the symptoms-to-endoscopy vs. presentation-to-endoscopy timeframes. The symptoms-to-endoscopy timeframe demonstrated (1) a different death risk profile and (2) a statistically significant improvement in the prediction of mortality risk compared to the presentation-to-endoscopy timeframe (p < 0.0002). The similarity between the two different timeframes was moderate (K = 0.42 ± 0.01; p < 0.001). Conclusions: The symptoms-to-endoscopy and presentation-to-endoscopy timeframes referred to different timings during the management of upper endoscopy in bleeding patients, with the former being more accurate in correctly identifying the mortality risk of these patients. We suggest that further studies be conducted to validate our observations, and, if confirmed, a different definition of time should be adopted in endoscopy. MDPI 2023-03-28 /pmc/articles/PMC10094998/ /pubmed/37048626 http://dx.doi.org/10.3390/jcm12072542 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Marmo, Riccardo
Soncini, Marco
Bucci, Cristina
Marmo, Clelia
Riccioni, Maria Elena
Defining Time in Acute Upper Gastrointestinal Bleeding: When Should We Start the Clock?
title Defining Time in Acute Upper Gastrointestinal Bleeding: When Should We Start the Clock?
title_full Defining Time in Acute Upper Gastrointestinal Bleeding: When Should We Start the Clock?
title_fullStr Defining Time in Acute Upper Gastrointestinal Bleeding: When Should We Start the Clock?
title_full_unstemmed Defining Time in Acute Upper Gastrointestinal Bleeding: When Should We Start the Clock?
title_short Defining Time in Acute Upper Gastrointestinal Bleeding: When Should We Start the Clock?
title_sort defining time in acute upper gastrointestinal bleeding: when should we start the clock?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10094998/
https://www.ncbi.nlm.nih.gov/pubmed/37048626
http://dx.doi.org/10.3390/jcm12072542
work_keys_str_mv AT marmoriccardo definingtimeinacuteuppergastrointestinalbleedingwhenshouldwestarttheclock
AT soncinimarco definingtimeinacuteuppergastrointestinalbleedingwhenshouldwestarttheclock
AT buccicristina definingtimeinacuteuppergastrointestinalbleedingwhenshouldwestarttheclock
AT marmoclelia definingtimeinacuteuppergastrointestinalbleedingwhenshouldwestarttheclock
AT riccionimariaelena definingtimeinacuteuppergastrointestinalbleedingwhenshouldwestarttheclock
AT definingtimeinacuteuppergastrointestinalbleedingwhenshouldwestarttheclock