Urgent endoscopy is associated with lower mortality in high-risk but not low-risk nonvariceal XXXX .

@entity1 @entity18880 @entity360
BACKGROUND AND STUDY AIMS: The role of urgent endoscopy in high-risk nonvariceal @entity360 (NVUGIB) is unclear. The aim of this study was to determine whether esophagogastroduodenoscopy (EGD) performed sooner than the currently recommended 24 h in high-risk @entity1 presenting with NVUGIB is associated with lower all-cause in-hospital mortality. METHODS: All adult @entity1 undergoing EGD for the indications of coffee-grounds vomitus, hematemesis or melena at a university hospital over an 18-month period were enrolled. @entity1 with variceal and lower @entity360 were excluded. Data were prospectively collected. RESULTS: A total of 934 @entity1 were included. The area under the receiver operating characteristic curve (AUROC) for the @entity18880 ( @entity18880 ) was 0.813 for predicting all-cause in-hospital mortality, with a cut-off score of >=  12 resulting in 90 % specificity. In low-risk @entity1 with @entity18880 < 12, presentation-to-endoscopy time in those who died and in those who survived was similar. In high-risk @entity1 with @entity18880 of >=  12, presentation-to-endoscopy time was significantly longer in those who died than in those who survived. Multivariate analysis of the high-risk cohort showed presentation-to-endoscopy time to be the only factor associated with all-cause in-hospital mortality. For high-risk @entity1 , the AUROC for presentation-to-endoscopy time in predicting all-cause in-hospital mortality was 0.803, with a sensitivity of 100 % at the cut-off time of 13 h. All-cause in-hospital mortality in high-risk @entity1 was significantly higher in those with presentation-to-endoscopy time of > 13 h compared with those undergoing endoscopy in < 13 h from presentation (44 % vs. 0 %; P < 0.001). CONCLUSIONS: Endoscopy within 13 h of presentation was associated with lower mortality in high-risk but not low-risk NVUGIB.
