Abstract:
BACKGROUND:Nonvariceal upper GI bleeding (NVUGIB) that occurs in patients already hospitalized for another condition is associated with increased mortality, but outcome predictors have not been consistently identified. OBJECTIVE:To assess clinical outcomes of NVUGIB and identify predictors of mortality from NVUGIB in patients with in-hospital bleeding compared with outpatients. DESIGN:Secondary analysis of prospectively collected data from 2 nationwide multicenter databases. Descriptive, inferential, and multivariate logistic regression models were carried out in 338 inpatients (68.6 ± 16.4 years of age, 68% male patients) and 1979 outpatients (67.8 ± 17 years of age, 66% male patients). A predictive model was constructed using the risk factors identified at multivariate analysis, weighted according to the contribution of each factor. SETTINGS:A total of 23 Italian community and tertiary care centers. PATIENTS:Consecutive patients admitted for acute NVUGIB. INTERVENTIONS:Early endoscopy, medical and endoscopic treatment as appropriate. MAIN OUTCOME MEASUREMENTS:Recurrent bleeding, surgery, and 30-day mortality. RESULTS:The mortality rate in patients with in-hospital bleeding was significantly higher than that in outpatients (8.9% vs 3.8%; odds ratio [OR] 2.44; 95% confidence interval [CI], 1.57-3.79; P < .0001). Hemodynamic instability on presentation (OR 7.31; 95% CI, 2.71-19.65) and the presence of severe comorbidity (OR 6.72; 95% CI, 1.87-24.0) were the strongest predictors of death for in-hospital bleeders. Other independent predictors of mortality were a history of peptic ulcer disease and failed endoscopic treatment. Rebleeding was a strong predictor of death only for outpatients (OR 5.22; 95% CI, 2.45-11.10). Risk factors had a different prognostic impact on the 2 populations, resulting in a significantly different prognostic accuracy of the model (area under the receiver-operating characteristic curve = 0.83; 95% CI, 0.77-0-93 vs 0.74; 95% CI, 0.68-0.80; P < .02). LIMITATIONS:Study design not experimental, no data on ward specialty, potential referral bias. CONCLUSIONS:In-hospital bleeders have a significantly higher risk of death because they are sicker and more often hemodynamically unstable than outpatients. Predictors of death have a different impact in the 2 populations.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Marmo R,Koch M,Cipolletta L,Bianco MA,Grossi E,Rotondano G,PNED 1 and PNED 2 Investigators.doi
10.1016/j.gie.2013.10.009subject
Has Abstractpub_date
2014-05-01 00:00:00pages
741-749.e1issue
5eissn
0016-5107issn
1097-6779pii
S0016-5107(13)02440-1journal_volume
79pub_type
杂志文章,多中心研究abstract:BACKGROUND:Pancreatic stents may occlude with time, and there is little information available on the nature of the clogging process. METHODS:We analyzed the contents of occluded pancreatic polyethylene stents in nine patients with chronic pancreatitis. In the same patients, the protein patterns in the corresponding pa...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(97)70302-x
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND AND AIMS:Optical diagnosis allows for real-time endoscopic assessment of colorectal polyp histology and consists of the resect and discard and diagnose and leave paradigms. This survey assessed patient acceptance of optical diagnosis and their responses to a hypothetical doomsday scenario. METHODS:We conduc...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2016.11.031
更新日期:2017-08-01 00:00:00
abstract::Hot biopsy forceps technique involves the use of insulated monopolar electrocoagulating forceps to simultaneously biopsy and electrocoagulate tissue. It has been recommended for removal of diminutive polyps and treatment of vascular ectasias of the gastrointestinal tract. The extent of its use and associated complicat...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(88)71226-2
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Endoscopic balloon dilation has been used to treat patients with gastric outlet obstruction caused by peptic stricture. This study assessed the role of endoscopic balloon dilation in patients with gastric outlet obstruction with or without Helicobacter pylori infection. METHODS:Consecutive patients seen bet...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)01569-x
更新日期:2004-08-01 00:00:00
abstract::Chronic radiation proctopathy is a common sequela of radiation therapy for malignancies in the pelvic region. A variety of medical and endoscopic therapies have been used for the management of bleeding from chronic radiation proctopathy. In this guideline, we reviewed the results of a systematic search of the literatu...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,实务指引
doi:10.1016/j.gie.2019.04.234
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND AND AIMS:Numerous randomized studies have shown that changing certain features of colonoscopes, usually incorporated when switching from one endoscope generation to the next, mostly do not increase adenoma yield. There is, however, indirect evidence that it may be necessary to skip one instrument generation ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.gie.2018.01.025
更新日期:2018-07-01 00:00:00
abstract::Omeprazole is a potent antisecretory drug that acts by inhibiting the gastric proton pump. In the present study, we have observed the effects of this drug on gastrointestinal mucosal perfusion, oxygenation, and hexosamine generation in humans. Sixteen healthy volunteers were included. Gastrointestinal mucosal perfusio...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0016-5107(05)80010-0
更新日期:1995-05-01 00:00:00
abstract::Obstruction of the main pancreatic duct with secondary upstream ductal hypertension is one cause of pain in patients with pancreatic cancer. Pancreatic endoscopic stenting and decompression of the pancreatic duct have been effective in the treatment of pain secondary to chronic calcifying pancreatitis and in one case ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(93)70263-1
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND AND AIMS:Digital cholangioscopes provide higher-resolution imaging of the pancreatobiliary tract compared with fiberoptic instruments. The role of a new, digital, single-operator cholangiopancreatoscopy (SOC) system for diagnosis and treatment of pancreatobiliary disorders in clinical practice is not known. ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2016.03.789
更新日期:2016-10-01 00:00:00
abstract::Absolute alcohol is a potentially optimal agent for sclerotherapy of esophageal varices. It is cheap and readily available. We compared the efficacy and safety of alcohol with those of a commonly used sclerosing agent, polidocanol. The study was planned to include patients with previous bleeding from esophageal varice...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0016-5107(88)71404-2
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:Use of an echocolonoscope to examine patients with inflammatory bowel disease is technically difficult. Catheter probe assisted endoluminal ultrasonography (US) may be a feasible alternative. METHODS:Determination of demographic information and clinical disease activity was followed by colonoscopy with biop...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(99)70342-1
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Photodynamic therapy appears to be effective in ablating high-grade dysplasia in Barrett's esophagus. Our aim was to identify the most effective and cost-effective strategy for managing high-grade dysplasia in Barrett's esophagus without associated endoscopically visible abnormalities. METHODS:By using deci...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)02167-4
更新日期:2004-11-01 00:00:00
abstract::Gastroenterologists are frequently asked to perform a variety of endoscopic procedures in patients with AIDS. A study published 6 years ago concluded that costly and inefficient practices resulted from anxiety about transmitting human immunodeficiency virus (HIV) to endoscopic personnel. We re-examined, by means of a ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(94)70214-4
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND AND AIMS:The risk of colorectal cancer (CRC) in various chronic liver diseases compared with the general population remains unclear. We performed a systematic review and meta-analysis to assess the risk of CRC in patients with chronic liver diseases before and after liver transplantation. METHODS:Electronic...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.gie.2016.12.009
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND AND AIMS:The clinical significance of a family history (FH) of colorectal cancer (CRC) in first-degree relatives (FDRs) in CRC screening stratified by different age groups of screened individuals is not fully understood. We investigated the relationship between FH and the presence of advanced colorectal neop...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2020.01.033
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Although linked with perforation, serositis, delayed bleeding, and incomplete resection, hot biopsy forceps electrocauterization (HBF) is still widely used for diminutive colonic polypectomy. OBJECTIVE:To evaluate the safety and efficacy of HBF in comparison with conventional snare polypectomy (CSP). DESIG...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2012.09.014
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Roux-en-Y gastric bypass is the most frequently performed bariatric surgery for morbid obesity. Gastrojejunal anastomotic strictures are a relatively frequent postoperative complication. OBJECTIVE:To evaluate the clinical outcomes and therapeutic response to through-the-scope balloon dilation performed to t...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.10.012
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Endosonographic evaluation and sampling of right colonic subepithelial lesions is technically difficult. OBJECTIVE:To evaluate the feasibility, safety, and tissue yield of a prototype front-view, forward-array, curved linear array echoendoscope in the evaluation and sampling of right colonic subepithelial l...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.03.1126
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Effective hemostatic treatment is mandatory for patients with actively bleeding Mallory-Weiss syndrome. This study evaluated the respective efficacy and the safety of endoscopic band ligation and endoscopic epinephrine injection in Mallory-Weiss syndrome. METHODS:Thirty-four consecutive patients with active...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0016-5107(04)01284-2
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Confocal laser endomicroscopy (CLE) may be used to diagnose gastric cancer and intestinal metaplasia, but the impact of CLE experience on the accuracy of confocal diagnosis of gastric cancer and intestinal metaplasia is not clear. OBJECTIVE:To establish the sensitivity, specificity, and intragroup interobse...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2011.01.068
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND AND AIMS:During endoscopic submucosal dissection (ESD), a clear view is essential for precise dissection of the appropriate submucosal layer. Some advantages have been reported for underwater techniques of endoscopic resection in comparison with the gas insufflation method. We have developed a new ESD method...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2018.04.2331
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Autoimmune pancreatitis has been proposed as a new clinical entity. However, the ERCP features of this entity have not been well described. METHODS:Clinical and radiographic features in 27 patients with a diagnosis of autoimmune pancreatitis were evaluated. RESULTS:All 27 patients were at first suspected t...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.122653
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND AND AIMS:Accidental and intentional foreign body ingestions are common and frequently require endoscopic intervention. Sharp metallic objects pose a risk of perforation to the entire GI tract and are often difficult to visualize among food and other matter in the stomach. METHODS:Three patients with histori...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2019.10.023
更新日期:2020-02-01 00:00:00
abstract::Malignant obstruction of the pancreaticobiliary system is a frequent indication for ERCP. Twenty-five patients with abnormalities suggestive of malignancy were encountered during ERCP at our institution and brush cytology was obtained. Positive cytology specimens were collected in 12 of 20 (60%) cases of malignancy ca...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(90)71024-3
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Celiac ganglia have not been previously identified by EUS. OBJECTIVE:To assess whether celiac ganglia can be detected by EUS and to define their characteristics. DESIGN:Retrospective review followed by prospective study. METHODS:Retrospective characterization was performed of all celiac ganglia that were ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.01.071
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Comprehensive, population-based data on ERCP use over the last 30 years in North America are lacking. OBJECTIVE:To establish crude and age-adjusted population-based rates of ERCP, evaluate for changing indications for ERCP, and evaluate for interactions between cholecystectomy technique and ERCP use from 19...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2013.08.028
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND AND AIMS:Submucosal injection is currently used in GI endoscopy to reduce resection risks and to perform submucosal dissection; it is usually performed via an injection needle or a needleless device. The aim of the study was to compare 2 submucosal injection modalities (needle-assisted vs needleless) by usin...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2017.01.029
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:It has been reported that the occurrence of acute cholangitis is common, especially when the self-expanding metal stent (SEMS) is placed across the main duodenal papilla. OBJECTIVE:To determine the incidence of duodenobiliary reflux and acute cholangitis after placement of SEMSs across the main duodenal pap...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2008.12.054
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Diagnosis of pancreatic exocrine insufficiency (PEI) is hindered by methodological difficulties of pancreatic function tests. The probability of PEI in chronic pancreatitis (CP) increases as pancreatic fibrosis develops. Pancreatic fibrosis in CP may be quantified by EUS elastography. OBJECTIVE:To evaluate ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.06.040
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate the efficacy and the safety of the covered Wallstent, a commercially available silicone-covered, self-expandable metallic stent (covered Wallstent), for the treatment of distal malignant biliary obstruction. METHODS:Sixty-nine consecutive patients with unresectable dist...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2005.06.030
更新日期:2005-11-01 00:00:00