Urgent versus early endoscopy in outcome of upper gastrointestinal bleeding in patients admitted in a tertiary care hospital of Nepal

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Background : There is a general consensus that upper gastrointestinal (UGI) endoscopy should be performed within 24 hours in patients presenting with UGI bleeding. However, the optimal timing within this period remains controversial, particularly regarding urgent endoscopy (within 12 hours of hospital presentation) versus early endoscopy (within 12–24 hours). This study aims to evaluate the association between the timing of endoscopy and clinical outcomes in patients with UGI bleeding. Method : We conducted a prospective, observational hospital-based study at Patan Hospital, Lalitpur, Nepal. The study aimed to compare outcomes in UGI bleeding patients undergoing urgent and early endoscopy. Consecutive sampling was employed. Outcomes assessed included in-hospital mortality, need for endoscopic intervention, requirement for repeat endoscopy, blood transfusion, and length of hospital stay in both groups. Results : A total of 84 patients were enrolled, with 42 patients in each group. Baseline characteristics were comparable between the groups, except for platelet count. Patients undergoing urgent endoscopy required more blood transfusions (76.19% vs. 52.38%, p = 0.023). There were no statistically significant differences between the groups in terms of endoscopic intervention, need for repeat endoscopy, or in-hospital mortality. However, the length of hospital stay was significantly shorter in the early endoscopy group (median 5 vs. 6 days, p = 0.021). Conclusions : Patients undergoing urgent endoscopy had higher transfusion requirements and longer hospital stay compared to early endoscopy, with no differences in other outcomes. Further randomized studies are needed to establish definitive recommendation.

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