Mo1163 Prevalence and Impact of Upper Gastrointestinal Bleeding on In-Hospital Mortality and Hospital Resource Utilization Among Patients With Solid Organ Transplantation

Abstract

Background: The optimum timeframe for the performance of endoscopy in patients with upper gastrointestinal bleeding remains unclear, not only in relation patient outcome or prognosis, but also in terms of the financial implications of providing access to endoscopy for 24 hours, which is of utmost importance to developing countries since the health system cannot provide access to endoscopies 24 hours a day. Objective: to compare the outcomes associated with early endoscopy (<24 hours) compared with delayed endoscopy in nonvariceal upper gastrointestinal bleeding. Material and Methods: Prospectively data of patients with upper gastrointestinal bleeding was collected during the months of October 2013 to August 2014. We excluded patients with variceal bleeding or those who a history of malignancy. We divided the patients into two groups: early and delayed endoscopy and compared: re-bleeding, need for surgery, hospital stay, number of packed cells transfused and mortality. We used Student t test for quantitative variables and chi-square or Fisher exact test for categorical variables, and relative risk for comparison of risk between groups in EpiInfo (version 7.1.3.3). Results: 147 patients were included, 48.3% early endoscopy, age 55.5 ± 17.96 years. There is no significant difference on the levels of hemoglobin (9.99 g / dL vs 10.53 g / dL p = 0.312), blood urea nitrogen (36.26 mg / dL vs 35.45 mg / dL p = 0.550); scores of Blatchford (8.66 vs 7.51, p = 0.078) and Rockall (3.66 vs 3.14, p = 0.225); the presence of orthostatic hypotension (15.5% vs 21.1%, p= 384) or hypovolemic shock (16.9% vs 11.8%, p = 0.381) in patients undergoing early and delayed endoscopy, respectively. Being the main causes gastric ulcer (38.77%), esophagitis (17.7%), gastritis / abrasions (17%), and duodenal ulcer (17%). Early endoscopy was associated with a significant decrease in the risk of re-bleeding (7% vs 19.7% RR 0.356, 95% CI 0.137-0.931, p = 0.0249), but a non-significant difference in hospital stay (3.89 vs 4.40, 95% CI -0.841 to 1.866, p = 0.455), the amount of packed cell units transfused (2.14 vs 2.58, 95% CI 0.631 to 1.503, p 0.411) mortality (2.8% vs. 3.9% RR 0.714, 95% CI 0.1234.147, p = 0.706).Conclusions: In this study, we found that there is statistically significant difference in the risk of rebleeding between early vs delayed endoscopy, but no difference in length of hospital stay, the number of units of packed cell transfusion and mortality among patients undergoing early vs delayed endoscopy BASELINE CHARACTERISTICS