Methodology: 3/5
Usefulness: 3.5/5

Lau JYW, et al. N Engl J Med. 2020 Apr 2;382(14):1299-1308.

Question and Methods: Single centre RCT comparing whether urgent (<6h) endoscopy improved outcomes compared to early endoscopy (6-24h) in patients presenting with high-risk UGIB (GBS>12).
Findings: No difference in 30-day mortality amongst patients with high risk UGIB who underwent urgent endoscopy (8.9%) compared to those who underwent early endoscopy (6.6%).
Limitations: Excluded patients who were hemodynamically unstable. Used timing of endoscopy from GI consult instead of time of initial presentation.

Interpretation: It may be safe to wait 6-24h for endoscopy in patients with high-risk UGIB as long as endoscopy is available sooner if the patient decompensates.

By: Dr. Jim Yang

Hans Rosenberg
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.