The role of endoscopy in triage of patients with upper-GI bleeding

Commentary

In the United States, upper GI (UGI) bleeding is a common clinical problem requiring more than 300,000 hospitalizations annually. Changes in practice over the last 10 years show that hospitalization days have significantly decreased and that the majority of patients with UGI bleeding undergo endoscopy within 24 hours of admission. Of these endoscopies, 20% to 35% include endoscopic hemostatic therapy. Early endoscopy (within 24 hours of hospital admission) has a greater impact than later endoscopy on length of hospital stay and requirements for blood transfusion. Dr. Lee discusses the value of preadmission endoscopy as a triage tool. The prognostic accuracy of the endoscopic results is sufficient to safely prevent hospitalization for a large number of patients.

Grace Elta, MD

Editor