Routine early endoscopy in upper-gastrointestinal-tract bleeding. A randomized, controlled trial

W. L. Peterson, C. C. Barnett, H. J. Smith, M. H. Allen, D. B. Corbett

Research output: Contribution to journalArticle

141 Citations (Scopus)

Abstract

To determine whether routine early endoscopy is beneficial to patients with upper-gastrointestinal-tract bleeding that ceases during hospitalization, we randomly assigned 206 patients to routine endoscopy (100 patients) or no routine endoscopy (106). Patients in the latter group underwent endoscopy only if recurrent bleeding occurred during hospitalization or if x-ray films disclosed gastric ulcer or suggested neoplasia. All patients were initially treated with an empiric antacid regimen. When the two groups were compared (experimental versus control), there were no significant differences in overall hospital deaths (11 versus eight), recurrence of bleeding (33 versus 32), number of transfusions required to treat recurrent bleeding (mean ± S.E.M., 7.4 ± 1.2 versus 6.3 ± 0.7 units), deaths after recurrent bleeding (eight versus five), or duration of hospital stay. During the 12 months after discharge, there were also no significant differences in frequency of readmission to the hospital, incidence of further gastrointestinal bleeding, number of hemorrhage-related deaths, or frequency of gastrointestinal surgery. We conclude that endoscopy should not be a routine procedure in patients with upper-gastrointestinal-tract bleeding that ceases during treatment.

Original languageEnglish (US)
Pages (from-to)925-929
Number of pages5
JournalNew England Journal of Medicine
Volume304
Issue number16
StatePublished - 1981

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Upper Gastrointestinal Tract
Endoscopy
Randomized Controlled Trials
Hemorrhage
Hospitalization
Patient Readmission
Antacids
Stomach Ulcer
Motion Pictures
Length of Stay
X-Rays
Recurrence
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Peterson, W. L., Barnett, C. C., Smith, H. J., Allen, M. H., & Corbett, D. B. (1981). Routine early endoscopy in upper-gastrointestinal-tract bleeding. A randomized, controlled trial. New England Journal of Medicine, 304(16), 925-929.

Routine early endoscopy in upper-gastrointestinal-tract bleeding. A randomized, controlled trial. / Peterson, W. L.; Barnett, C. C.; Smith, H. J.; Allen, M. H.; Corbett, D. B.

In: New England Journal of Medicine, Vol. 304, No. 16, 1981, p. 925-929.

Research output: Contribution to journalArticle

Peterson, WL, Barnett, CC, Smith, HJ, Allen, MH & Corbett, DB 1981, 'Routine early endoscopy in upper-gastrointestinal-tract bleeding. A randomized, controlled trial', New England Journal of Medicine, vol. 304, no. 16, pp. 925-929.
Peterson, W. L. ; Barnett, C. C. ; Smith, H. J. ; Allen, M. H. ; Corbett, D. B. / Routine early endoscopy in upper-gastrointestinal-tract bleeding. A randomized, controlled trial. In: New England Journal of Medicine. 1981 ; Vol. 304, No. 16. pp. 925-929.
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