Does Conservative Management In Upper Gi Bleeding During Covid-19 Lead On To Adverse Outcomes?

Aims We aimed to assess outcomes of patients with upper gastrointestinal bleeding (UGIB) during the Covid-19 induced 1^st lockdown during the pandemic in our unit who were either managed conservatively without endoscopy or with endoscopy.

Methods We analysed 81 patients retrospectively, who were admitted between 23/03/2020 and 31/05/2020 (First national lockdown period) and managed as confirmed or suspected UGIB during their admission. We collected;

• clinical details, laboratory results, endoscopic findings and management.

• Risk assessment; Charlson Comorbidity Index, Glasgow-Blatchford Bleeding Score (GBS) and Rockall score (pre and post-endoscopy)

• Outcomes; length of hospital stay, ITU admission, rebleeding and 30-day all-cause mortality.

Results 81 patients were enrolled; 44 patients had endoscopy (group A) while 37 patients received conservative management (group B) based on clinical decision.

There was no significant difference regarding age (Mean 64.6 yrs. for A, 67.4 yrs. for B), Charlson comorbidities index (Mean 4.59 for A, 4.36 for B), systolic blood pressure (Mean was 118 for A, 126 for B), heart rate Mean 94.7 for A and 88.5 for B), Urea (Mean 10.8 for A and 10.6 for B) and Rockall pre endoscopy score (mean 3.77 for A and 3.43 for B).

There was no significant difference in outcome regarding; length of hospital stay (mean 8.36 for A and 6.64 for B), rebleed (9.09 % for A and 8.10 % for B), ITU admission (2.27 % for A and 5.4 % for B) and 30-day mortality (13.63 % for A and 18.91 % for B).

There was a significant difference between the two groups regarding Hb level and GBS score.

Tab. 1

	Endoscopy (group A)	Conservative (group B)
Total patients	44	37	81 patients
Covid positive	2.27 %	10.81 %	P value 0.17
Haemoglobin level (Hb)	Mean 86.9 g/l	Mean 103 g/l	P value 0.03
Glasgow Blatchford score (GBS)	Mean 9.65	Mean 7.81	P value 0.04

Conclusions There was no significant difference regarding the outcome in conservative and endoscopic management for UGIB during this period. Higher GBS and lower Hb were associated with a higher rate of endoscopic management. This supports the concept that correct triage for UGIB was not affected by the pandemic.

Citation Ghodeif A, Al-Rifaie A, Gawn A et al. eP486 DOES CONSERVATIVE MANAGEMENT IN UPPER GI BLEEDING DURING COVID-19 LEAD ON TO ADVERSE OUTCOMES?. Endoscopy 2021; 53: S258.

Publication History

Article published online:
19 March 2021