Acute Upper Gastrointestinal BleedingNCT05979025
Factors Predicting the Need for Endoscopic Intervention in Non-variceal Upper Gastrointestinal Bleeding
An observational study of Acute Upper Gastrointestinal Bleeding, run by Ankara City Hospital Bilkent at 1 site in Turkey (Türkiye).
Trial summary
Gastrointestinal system bleedings are medical emergencies and the most common cause of hospital admissions related to digestive system diseases. Gastrointestinal system bleedings are a frequently encountered condition and one of the significant reasons leading to morbidity, mortality, and medical care costs. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Acute Upper Gastrointestinal Bleeding
- How many people
- 262 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 11 Aug 2022to 7 Sep 2023
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Patients who are 18 years of age and older and present to our hospital with a diagnosis of non-variceal upper gastrointestinal bleeding, among whom endoscopy is performed within the first 24 hours after hospital admission
Who may be able to join
- Patients who present to our hospital with a diagnosis of non-variceal upper gastrointestinal bleeding
- Patients who undergo endoscopy within the first 24 hours after hospital admission
Who cannot join
- Patients who have variceal bleeding
- Lower gastrointestinal system bleeding
- Individuals who are under the age of 18
- Patients who do not undergo endoscopy within the first 24 hours after hospital admission
Trial locations and contacts
1 site in 1 country.
About this study
Gastrointestinal system bleedings are medical emergencies and the most common cause of hospital admissions related to digestive system diseases. Gastrointestinal system bleedings are a frequently encountered condition and one of the significant reasons leading to morbidity, mortality, and medical care costs. For acute upper gastrointestinal system bleedings, the annual hospital admission incidence in the United States is approximately 67 per 100,000 adults, making it more common than lower gastrointestinal system bleedings. Approximately 80% of acute upper gastrointestinal system bleedings are attributed to non-variceal causes. Endoscopy is an invasive procedure used for diagnosis and treatment in upper gastrointestinal system bleedings. . In recent years, there has been an increase in endoscopy and endoscopic treatment rates. Except for variceal bleedings, most upper gastrointestinal system bleedings stop without the need for endoscopic intervention. However, some patients require endoscopic intervention and identifying this high-risk group, prone to recurrent bleeding, through non-invasive tests is crucial. In investigators' prospective study, researcher aimed to facilitate the identification of patients who require intervention and undergo endoscopic intervention (e.g., epinephrine injection, hemoclips, thermal coagulation, argon plasma coagulation, etc.) among those who underwent endoscopy within the first 24 hours after admission to the hospital's emergency department with a diagnosis of non-variceal acute upper gastrointestinal system bleeding. Investigators sought to achieve this by determining the relevant parameters related to their clinical and laboratory findings, comorbidities, and demographic characteristics at the time of admission. This approach aims to reduce hospital admissions, hospital stay, and costs, and particularly to minimize interventional procedures during seizures and decrease complications.As of August 2022, patients who applied to the Ankara Bilkent City Hospital emergency department were followed up.
Read the detailed description
Gastrointestinal system bleedings are medical emergencies and the most common cause of hospital admissions related to digestive system diseases. Gastrointestinal system bleedings are a frequently encountered condition and one of the significant reasons leading to morbidity, mortality, and medical care costs. For acute upper gastrointestinal system bleedings, the annual hospital admission incidence in the United States is approximately 67 per 100,000 adults, making it more common than lower gastrointestinal system bleedings. A decrease in the incidence of non-variceal acute upper gastrointestinal system bleeding has been observed compared to previous years, which is believed to be associated with an increase in the use of proton pump inhibitors (PPIs), eradication of Helicobacter pylori (H. pylori), and advancements in endoscopic treatment. Approximately 80% of acute upper gastrointestinal system bleedings are attributed to non-variceal causes.
Endoscopy is an invasive procedure used for diagnosis and treatment in upper gastrointestinal system bleedings. In recent years, there has been an increase in endoscopy and endoscopic treatment rates. Previous studies have identified higher mortality rates, around 5-10% for bleeding due to peptic ulcers, and approximately 15% for esophageal variceal bleedings. The development of modern endoscopy has led to significant advancements in various therapeutic techniques. Mortality related to all causes of upper gastrointestinal system bleedings has declined due to advancements in treatment. In recent years, there has been a decrease in hospitalization duration and mortality, but the total economic burden has significantly increased.
Except for variceal bleedings, most upper gastrointestinal system bleedings stop without the need for endoscopic intervention. However, some patients require endoscopic intervention and identifying this high-risk group, prone to recurrent bleeding, through non-invasive tests is crucial. In cases where endoscopic treatment is insufficient, surgical or interventional radiology procedures such as embolization may be necessary. Endoscopic treatment has led to a reduction in the need for surgery and blood transfusions in patients presenting with upper gastrointestinal system bleeding. The goal of treatment is to prevent complications and deaths. Determining the need for treatment for a patient is clinically and practically easier than predicting who will die or re-bleed.
Gastrointestinal bleedings can lead to various clinical scenarios due to multiple lesion types, and they can occur from any part of the gastrointestinal system, either overtly or covertly. Upper gastrointestinal bleedings are approximately 5 times more common than lower gastrointestinal bleedings. Several scoring systems, such as Glasgow-Blatchford, Rockall, AIMS65, have been developed to predict the need for endoscopic intervention, risk of re-bleeding, and 30-day mortality in non-variceal bleedings.
Emergency upper gastrointestinal endoscopy is performed within the first 12 hours in high-risk patients who present to the hospital's emergency department with acute upper gastrointestinal system bleeding. However, it may not always be feasible to adhere to this timeframe, and endoscopy can be performed up to 24 hours after appropriate resuscitation, depending on the expertise of the personnel.
In investigators' prospective study, researcher aimed to facilitate the identification of patients who require intervention and undergo endoscopic intervention (e.g., epinephrine injection, hemoclips, thermal coagulation, argon plasma coagulation, etc.) among those who underwent endoscopy within the first 24 hours after admission to the hospital's emergency department with a diagnosis of non-variceal acute upper gastrointestinal system bleeding. Investigators sought to achieve this by determining the relevant parameters related to their clinical and laboratory findings, comorbidities, and demographic characteristics at the time of admission. This approach aims to reduce hospital admissions, hospital stay, and costs, and particularly to minimize interventional procedures during seizures and decrease complications. As of August 2022, patients who applied to the Ankara Bilkent City Hospital emergency department were followed up.
- Conditions
- Acute Upper Gastrointestinal Bleeding
What is being measured
The primary outcome is the main question the study is designed to answer.
Endoscopic intervention
Mechanical treatment (eg hemoclips, tape, etc.), injection therapy (eg epinephrine etc.), thermal coagulation (eg heater probe etc.)
Measured: First 24 hours after hospital admission
Secondary outcomes (3)
İntensive care hospitalization
Intensive care unit (ICU) admission of patients presenting to the hospital due to non-variceal upper gastrointestinal system bleeding either at the time of admission or within 30 days after hospitalization for any reason.
Measured: 30 days after admission to hospital
Mortality
Death within 30 days of hospital admission with non-variceal upper gastrointestinal bleeding
Measured: 30 days after admission to hospital
Rebleeding
Rebleeding within 30 days of hospital admission with non-variceal upper gastrointestinal bleeding
Measured: 30 days after admission to hospital
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Aug 2023
- Study start11 Aug 2022
- Primary completion29 Jul 2023
- Study completion7 Sep 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for Acute Upper Gastrointestinal BleedingStudies of the same condition, open and under way.
- More trials run by Ankara City Hospital BilkentThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 262 participants (actual)
Sponsor and investigators
- Lead sponsor
- Ankara City Hospital Bilkent
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Numan Aydın, Ankara City Hospital Bilkent
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05979025
- Sponsor's protocol ID
- AnkaraCHBilkent-NA-TEZ
- Status last verified
- Feb 2024
- First submitted
- 30 Jul 2023
- Last updated
- 16 Feb 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Wuerth BA, Rockey DC. Changing Epidemiology of Upper Gastrointestinal Hemorrhage in the Last Decade: A Nationwide Analysis. Dig Dis Sci. 2018 May;63(5):1286-1293. doi: 10.1007/s10620-017-4882-6. Epub 2017 Dec 27.
PubMed 29282637Abougergi MS, Travis AC, Saltzman JR. The in-hospital mortality rate for upper GI hemorrhage has decreased over 2 decades in the United States: a nationwide analysis. Gastrointest Endosc. 2015 Apr;81(4):882-8.e1. doi: 10.1016/j.gie.2014.09.027. Epub 2014 Dec 5.
PubMed 25484324Masaoka T, Suzuki H, Hori S, Aikawa N, Hibi T. Blatchford scoring system is a useful scoring system for detecting patients with upper gastrointestinal bleeding who do not need endoscopic intervention. J Gastroenterol Hepatol. 2007 Sep;22(9):1404-8. doi: 10.1111/j.1440-1746.2006.04762.x.
PubMed 17716345Chen IC, Hung MS, Chiu TF, Chen JC, Hsiao CT. Risk scoring systems to predict need for clinical intervention for patients with nonvariceal upper gastrointestinal tract bleeding. Am J Emerg Med. 2007 Sep;25(7):774-9. doi: 10.1016/j.ajem.2006.12.024.
PubMed 17870480Lanas A, Dumonceau JM, Hunt RH, Fujishiro M, Scheiman JM, Gralnek IM, Campbell HE, Rostom A, Villanueva C, Sung JJY. Non-variceal upper gastrointestinal bleeding. Nat Rev Dis Primers. 2018 Apr 19;4:18020. doi: 10.1038/nrdp.2018.20.
PubMed 29671413Kamboj AK, Hoversten P, Leggett CL. Upper Gastrointestinal Bleeding: Etiologies and Management. Mayo Clin Proc. 2019 Apr;94(4):697-703. doi: 10.1016/j.mayocp.2019.01.022.
PubMed 30947833Wilkins T, Wheeler B, Carpenter M. Upper Gastrointestinal Bleeding in Adults: Evaluation and Management. Am Fam Physician. 2020 Mar 1;101(5):294-300.
PubMed 32109037Rockey DC. Gastrointestinal bleeding. Gastroenterol Clin North Am. 2005 Dec;34(4):581-8. doi: 10.1016/j.gtc.2005.08.002.
PubMed 16303571Lakatos L, Gonczi L, Lontai L, Izbeki F, Patai A, Racz I, Gasztonyi B, Varga-Szabo L, Ilias A, Lakatos PL. Incidence, Predictive Factors, Clinical Characteristics and Outcome of Non-variceal Upper Gastrointestinal Bleeding - A Prospective Population-based Study from Hungary. J Gastrointestin Liver Dis. 2021 Sep 21;30(3):327-333. doi: 10.15403/jgld-3495.
PubMed 34375379
Study at a glance
From the registry record, last updated by the sponsor on 16 Feb 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Factors Predicting the Need for Endoscopic Intervention in Non-variceal Upper Gastrointestinal Bleeding
- ClinicalTrials.gov ID
- NCT05979025
- Acronym / sponsor ID
- AnkaraCHBilkent-NA-TEZ
- Conditions
- Acute Upper Gastrointestinal Bleeding
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 262 participants (actual)
- Lead sponsor
- Ankara City Hospital BilkentUniversity, hospital or other
- Study start
- 11 Aug 2022 (actual)
- Primary completion
- 29 Jul 2023 (actual)
- Study completion
- 7 Sep 2023 (actual)
- First posted
- 7 Aug 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Gastrointestinal system bleedings are medical emergencies and the most common cause of hospital admissions related to digestive system diseases. Gastrointestinal system bleedings are a frequently encountered condition and one of the significant reasons leading to morbidity, mortality, and medical care costs. For acute upper gastrointestinal system bleedings, the annual hospital admission incidence in the United States is approximately 67 per 100,000 adults, making it more common than lower gastrointestinal system bleedings. Approximately 80% of acute upper gastrointestinal system bleedings are attributed to non-variceal causes. Endoscopy is an invasive procedure used for diagnosis and treatment in upper gastrointestinal system bleedings. . In recent years, there has been an increase in endoscopy and endoscopic treatment rates. Except for variceal bleedings, most upper gastrointestinal system bleedings stop without the need for endoscopic intervention. However, some patients require endoscopic intervention and identifying this high-risk group, prone to recurrent bleeding, through non-invasive tests is crucial. In investigators' prospective study, researcher aimed to facilitate the identification of patients who require intervention and undergo endoscopic intervention (e.g., epinephrine injection, hemoclips, thermal coagulation, argon plasma coagulation, etc.) among those who underwent endoscopy within the first 24 hours after admission to the hospital's emergency department with a diagnosis of non-variceal acute upper gastrointestinal system bleeding. Investigators sought to achieve this by determining the relevant parameters related to their clinical and laboratory findings, comorbidities, and demographic characteristics at the time of admission. This approach aims to reduce hospital admissions, hospital stay, and costs, and particularly to minimize interventional procedures during seizures and decrease complications.As of August 2022, patients who applied to the Ankara Bilkent City Hospital emergency department were followed up.
Detailed description
Gastrointestinal system bleedings are medical emergencies and the most common cause of hospital admissions related to digestive system diseases. Gastrointestinal system bleedings are a frequently encountered condition and one of the significant reasons leading to morbidity, mortality, and medical care costs. For acute upper gastrointestinal system bleedings, the annual hospital admission incidence in the United States is approximately 67 per 100,000 adults, making it more common than lower gastrointestinal system bleedings. A decrease in the incidence of non-variceal acute upper gastrointestinal system bleeding has been observed compared to previous years, which is believed to be associated with an increase in the use of proton pump inhibitors (PPIs), eradication of Helicobacter pylori (H. pylori), and advancements in endoscopic treatment. Approximately 80% of acute upper gastrointestinal system bleedings are attributed to non-variceal causes.
Endoscopy is an invasive procedure used for diagnosis and treatment in upper gastrointestinal system bleedings. In recent years, there has been an increase in endoscopy and endoscopic treatment rates. Previous studies have identified higher mortality rates, around 5-10% for bleeding due to peptic ulcers, and approximately 15% for esophageal variceal bleedings. The development of modern endoscopy has led to significant advancements in various therapeutic techniques. Mortality related to all causes of upper gastrointestinal system bleedings has declined due to advancements in treatment. In recent years, there has been a decrease in hospitalization duration and mortality, but the total economic burden has significantly increased.
Except for variceal bleedings, most upper gastrointestinal system bleedings stop without the need for endoscopic intervention. However, some patients require endoscopic intervention and identifying this high-risk group, prone to recurrent bleeding, through non-invasive tests is crucial. In cases where endoscopic treatment is insufficient, surgical or interventional radiology procedures such as embolization may be necessary. Endoscopic treatment has led to a reduction in the need for surgery and blood transfusions in patients presenting with upper gastrointestinal system bleeding. The goal of treatment is to prevent complications and deaths. Determining the need for treatment for a patient is clinically and practically easier than predicting who will die or re-bleed.
Gastrointestinal bleedings can lead to various clinical scenarios due to multiple lesion types, and they can occur from any part of the gastrointestinal system, either overtly or covertly. Upper gastrointestinal bleedings are approximately 5 times more common than lower gastrointestinal bleedings. Several scoring systems, such as Glasgow-Blatchford, Rockall, AIMS65, have been developed to predict the need for endoscopic intervention, risk of re-bleeding, and 30-day mortality in non-variceal bleedings.
Emergency upper gastrointestinal endoscopy is performed within the first 12 hours in high-risk patients who present to the hospital's emergency department with acute upper gastrointestinal system bleeding. However, it may not always be feasible to adhere to this timeframe, and endoscopy can be performed up to 24 hours after appropriate resuscitation, depending on the expertise of the personnel.
In investigators' prospective study, researcher aimed to facilitate the identification of patients who require intervention and undergo endoscopic intervention (e.g., epinephrine injection, hemoclips, thermal coagulation, argon plasma coagulation, etc.) among those who underwent endoscopy within the first 24 hours after admission to the hospital's emergency department with a diagnosis of non-variceal acute upper gastrointestinal system bleeding. Investigators sought to achieve this by determining the relevant parameters related to their clinical and laboratory findings, comorbidities, and demographic characteristics at the time of admission. This approach aims to reduce hospital admissions, hospital stay, and costs, and particularly to minimize interventional procedures during seizures and decrease complications. As of August 2022, patients who applied to the Ankara Bilkent City Hospital emergency department were followed up.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients who are 18 years of age and older and present to our hospital with a diagnosis of non-variceal upper gastrointestinal bleeding, among whom endoscopy is performed within the first 24 hours after hospital admission
Key inclusion criteria (2 listed)
- Patients who present to our hospital with a diagnosis of non-variceal upper gastrointestinal bleeding
- Patients who undergo endoscopy within the first 24 hours after hospital admission
Key exclusion criteria (4 listed)
- Patients who have variceal bleeding
- Lower gastrointestinal system bleeding
- Individuals who are under the age of 18
- Patients who do not undergo endoscopy within the first 24 hours after hospital admission
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Endoscopic intervention
Time frame: First 24 hours after hospital admission
Mechanical treatment (eg hemoclips, tape, etc.), injection therapy (eg epinephrine etc.), thermal coagulation (eg heater probe etc.)
3 secondary outcomes
İntensive care hospitalization
Time frame: 30 days after admission to hospital
Mortality
Time frame: 30 days after admission to hospital
Rebleeding
Time frame: 30 days after admission to hospital
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Feb 2024.
- Results publication: PubMed 29282637Wuerth BA, Rockey DC. Changing Epidemiology of Upper Gastrointestinal Hemorrhage in the Last Decade: A Nationwide Analysis. Dig Dis Sci. 2018 May;63(5):1286-1293. doi: 10.1007/s10620-017-4882-6. Epub 2017 Dec 27.
- Results publication: PubMed 25484324Abougergi MS, Travis AC, Saltzman JR. The in-hospital mortality rate for upper GI hemorrhage has decreased over 2 decades in the United States: a nationwide analysis. Gastrointest Endosc. 2015 Apr;81(4):882-8.e1. doi: 10.1016/j.gie.2014.09.027. Epub 2014 Dec 5.
- Results publication: PubMed 17716345Masaoka T, Suzuki H, Hori S, Aikawa N, Hibi T. Blatchford scoring system is a useful scoring system for detecting patients with upper gastrointestinal bleeding who do not need endoscopic intervention. J Gastroenterol Hepatol. 2007 Sep;22(9):1404-8. doi: 10.1111/j.1440-1746.2006.04762.x.
- Results publication: PubMed 17870480Chen IC, Hung MS, Chiu TF, Chen JC, Hsiao CT. Risk scoring systems to predict need for clinical intervention for patients with nonvariceal upper gastrointestinal tract bleeding. Am J Emerg Med. 2007 Sep;25(7):774-9. doi: 10.1016/j.ajem.2006.12.024.
- Results publication: PubMed 29671413Lanas A, Dumonceau JM, Hunt RH, Fujishiro M, Scheiman JM, Gralnek IM, Campbell HE, Rostom A, Villanueva C, Sung JJY. Non-variceal upper gastrointestinal bleeding. Nat Rev Dis Primers. 2018 Apr 19;4:18020. doi: 10.1038/nrdp.2018.20.
- Results publication: PubMed 30947833Kamboj AK, Hoversten P, Leggett CL. Upper Gastrointestinal Bleeding: Etiologies and Management. Mayo Clin Proc. 2019 Apr;94(4):697-703. doi: 10.1016/j.mayocp.2019.01.022.
- Results publication: PubMed 32109037Wilkins T, Wheeler B, Carpenter M. Upper Gastrointestinal Bleeding in Adults: Evaluation and Management. Am Fam Physician. 2020 Mar 1;101(5):294-300.
- Results publication: PubMed 16303571Rockey DC. Gastrointestinal bleeding. Gastroenterol Clin North Am. 2005 Dec;34(4):581-8. doi: 10.1016/j.gtc.2005.08.002.
- Results publication: PubMed 34375379Lakatos L, Gonczi L, Lontai L, Izbeki F, Patai A, Racz I, Gasztonyi B, Varga-Szabo L, Ilias A, Lakatos PL. Incidence, Predictive Factors, Clinical Characteristics and Outcome of Non-variceal Upper Gastrointestinal Bleeding - A Prospective Population-based Study from Hungary. J Gastrointestin Liver Dis. 2021 Sep 21;30(3):327-333. doi: 10.15403/jgld-3495.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Acute Upper Gastrointestinal Bleeding, run by Ankara City Hospital Bilkent at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 16 Feb 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Endoscopic intervention (time frame: First 24 hours after hospital admission). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05979025, which also lists 9 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Feb 2024; AzTrials last refreshed its copy on 3 Nov 2026.