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논문 기본 정보

자료유형
학술저널
저자정보
이재환 (연세의대 응급의학교실) 유제성 (연세대학교) 박고은 (연세대학교) 박주영 (연세대학교) 정성필 (연세대학교) 공태영 (연세대학교) 범진호 (연세대학교) 고동률 (연세대학교 의과대학 응급의학교실)
저널정보
대한응급의학회 대한응급의학회지 대한응급의학회지 제32권 제5호
발행연도
2021.10
수록면
386 - 393 (8page)

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Objective: Endoscopic hemostasis is a key treatment for variceal upper gastrointestinal bleeding. However, the effects of early endoscopy in variceal upper gastrointestinal bleeding have not been sufficiently studied. This study investigated the effects of the use of the critical pathway (CP) for upper gastrointestinal bleeding. Methods: The study was designed as a ‘before and after’ study. A group of patients diagnosed with variceal upper gastrointestinal bleeding from January 1, 2011, to December 31, 2014, and CP activated patients from January 1, 2015, to December 31, 2018, were reviewed retrospectively. The study endpoints included an analysis of the following in the two groups: time from emergency department (ED) arrival to endoscopy, number of blood transfusions, hospitalization period, intensive care unit (ICU) admission, 30-day mortality. Results: From January 1, 2011, to December 31, 2018, 207 patients were admitted with variceal upper gastrointestinal bleeding, and 137 patients with a Blatchford score of 7 or higher were included in the study. Of these, 88 patients visited before the implementation of CP and 49 patients visited thereafter. The time from ED arrival to endoscopy was 218.1± 201.7 minutes in the CP activated group, which was about 200 minutes shorter (P=0.046) than the non-CP group. There was no statistical difference in 30-day mortality, transfusion, emergency room hospitalization time, number of ICU admissions, and hospitalization days (P=0.348, P=0.394, P=0.651, P=0.164, and P=0.069). Conclusion: After CP, the time to endoscopy was significantly shortened, but it did not reduce mortality.

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