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

Author

  • 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.