Abstract：
Guidelines for the management of upper gastrointestinal bleeding (UGIB) are regularly published, yet little is known concerning adherence to recommendations in practice.
We aimed to assess adherence to European Society of Gastrointestinal Endoscopy (ESGE) recommendations in patients with non-variceal UGIB.
All hospitalized patients with an esophagogastroduodenoscopy (EGD) performed due to suspected non-variceal UGIB at our department were included in a prospective registry. Data between 2018-2020 from this registry were retrospectively analyzed. Adherence to the 2015 ESGE bleeding and propofol sedation guidelines was assessed. Adherence to recommendations concerning preendoscopic (risk) evaluation, preendoscopic PPI, transfusion management, and endoscopic management of peptic ulcers was analyzed.
Among 1005 patients (mean age 70.4 years, 42.1% women) the most common bleeding etiologies were gastric or duodenal ulcers (16.8%), esophagitis/GERD (11.1%), and angiodysplasia (9.9%); mortality was 7.6%. Adherence to preendosopic risk evaluation was low, in 0% a Mallampati classification and in 37.5% an ASA scoring was documented. Preendoscopic PPI was started at 58.6%, and adherence to recommended transfusion management was >98%. Peptic ulcers were Forrest-graded in 72.8%. High-risk ulcers were treated appropriately in 77.9% and low-risk ulcers were not treated in 73.6%. Especially Forrest Ib ulcers were undertreated, with an adherence of 59.6%. Only 22/179 (12.3%) patients with peptic ulcers and early endoscopy were consistently managed according to ESGE recommendations.
Adherence to ESGE guidelines in patients with non-variceal UGIB is moderate to low, even at a tertiary university hospital. Strategies must be devised for guidelines to reach patients in everyday practice.
We aimed to assess adherence to European Society of Gastrointestinal Endoscopy (ESGE) recommendations in patients with non-variceal UGIB.
All hospitalized patients with an esophagogastroduodenoscopy (EGD) performed due to suspected non-variceal UGIB at our department were included in a prospective registry. Data between 2018-2020 from this registry were retrospectively analyzed. Adherence to the 2015 ESGE bleeding and propofol sedation guidelines was assessed. Adherence to recommendations concerning preendoscopic (risk) evaluation, preendoscopic PPI, transfusion management, and endoscopic management of peptic ulcers was analyzed.
Among 1005 patients (mean age 70.4 years, 42.1% women) the most common bleeding etiologies were gastric or duodenal ulcers (16.8%), esophagitis/GERD (11.1%), and angiodysplasia (9.9%); mortality was 7.6%. Adherence to preendosopic risk evaluation was low, in 0% a Mallampati classification and in 37.5% an ASA scoring was documented. Preendoscopic PPI was started at 58.6%, and adherence to recommended transfusion management was >98%. Peptic ulcers were Forrest-graded in 72.8%. High-risk ulcers were treated appropriately in 77.9% and low-risk ulcers were not treated in 73.6%. Especially Forrest Ib ulcers were undertreated, with an adherence of 59.6%. Only 22/179 (12.3%) patients with peptic ulcers and early endoscopy were consistently managed according to ESGE recommendations.
Adherence to ESGE guidelines in patients with non-variceal UGIB is moderate to low, even at a tertiary university hospital. Strategies must be devised for guidelines to reach patients in everyday practice.
摘要：
未经评估：上消化道出血（UGIB）的管理指南定期发布，然而，关于在实践中遵守建议的情况知之甚少。
UNASSIGNED：我们旨在评估非静脉曲张性UGIB患者对欧洲胃肠内镜学会（ESGE）建议的依从性。
UNASSIGNED：我们部门所有因怀疑非静脉曲张性UGIB而进行食管胃十二指肠镜检查（EGD）的住院患者均纳入前瞻性登记。回顾性分析了该注册表2018-2020年的数据。评估了对2015年ESGE出血和异丙酚镇静指南的依从性。遵守有关内镜前（风险）评估的建议，内镜前PPI,输血管理,并对消化性溃疡的内镜处理进行分析。
未经证实：在1005名患者中（平均年龄70.4岁，42.1%的女性)最常见的出血病因是胃或十二指肠溃疡(16.8%)，食管炎/GERD(11.1%),和血管发育不良(9.9%);死亡率为7.6%.对内皮前风险评估的依从性较低，Mallampati分级为0%,ASA评分为37.5%.内镜前PPI开始为58.6%，对推荐输血管理的依从性>98%.消化性溃疡的Forrest分级为72.8％。77.9％的高风险溃疡得到适当治疗，73.6％的低风险溃疡未得到治疗。特别是ForrestIb溃疡治疗不足，坚持59.6%。根据ESGE建议，只有22/179（12.3％）的消化性溃疡和早期内窥镜检查患者得到了一致的治疗。
UNASSIGNED：非静脉曲张性UGIB患者对ESGE指南的依从性为中等至低，甚至在三级大学医院。必须为指南制定策略，以在日常实践中接触患者。
UNASSIGNED：我们旨在评估非静脉曲张性UGIB患者对欧洲胃肠内镜学会（ESGE）建议的依从性。
UNASSIGNED：我们部门所有因怀疑非静脉曲张性UGIB而进行食管胃十二指肠镜检查（EGD）的住院患者均纳入前瞻性登记。回顾性分析了该注册表2018-2020年的数据。评估了对2015年ESGE出血和异丙酚镇静指南的依从性。遵守有关内镜前（风险）评估的建议，内镜前PPI,输血管理,并对消化性溃疡的内镜处理进行分析。
未经证实：在1005名患者中（平均年龄70.4岁，42.1%的女性)最常见的出血病因是胃或十二指肠溃疡(16.8%)，食管炎/GERD(11.1%),和血管发育不良(9.9%);死亡率为7.6%.对内皮前风险评估的依从性较低，Mallampati分级为0%,ASA评分为37.5%.内镜前PPI开始为58.6%，对推荐输血管理的依从性>98%.消化性溃疡的Forrest分级为72.8％。77.9％的高风险溃疡得到适当治疗，73.6％的低风险溃疡未得到治疗。特别是ForrestIb溃疡治疗不足，坚持59.6%。根据ESGE建议，只有22/179（12.3％）的消化性溃疡和早期内窥镜检查患者得到了一致的治疗。
UNASSIGNED：非静脉曲张性UGIB患者对ESGE指南的依从性为中等至低，甚至在三级大学医院。必须为指南制定策略，以在日常实践中接触患者。
