Upper GI bleed: complications from endoscopy were rare

Clinical bottom line (level 4)

  1. Less than 1% of patients undergoing endoscopy had a major complication (perforation, aspiration or haemorrhage).
Gilbert et al: Digestive Diseases and Sciences 1981; 26 (7): 55-59
Expires October 2002

The study

Case series with unblinded, unobjective outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: hospitals, USA

2097 patients (aged mean 57, 66.3% male) with upper gastrointestinal bleeding
All patients underwent endoscopy (66% as emergencies). 89% of endoscopies were considered complete.


Outcomes studied:
  • perforation
  • aspiration
  • haemorrhage
  • minor complications mucosal tear, medication reaction, hypotension, atrial fibrillation, anoxic episode

The evidence

outcome time to outcome number of patients/total number %
(95% CI)
perforation ? 5/2097 0.24%
(0.030% to 0.45%)
aspiration ? 4/2097 0.19%
(0.0040% to 0.38%)
haemorrhage ? 3/2097 0.14%
(0.0% to 0.30%)
minor complications ? 9/2097 0.43%
(0.15% to 0.71%)

Comments

  1. Data was collected from 277 members of the American Society of Gastrointestinal Endoscopy who responded to a questionnaire.
  2. Variability due to experience, endoscope design and volume of operation are not reported. Adverse events are probably less common today, as instrument design has evolved.

    Citation

    1. Gilbert DA, Silverstein FE, Tedesco FJ, et al: (supplement): National ASGE Survey on upper gastrointestinal bleeding - complications of endoscopy. Digestive Diseases and Sciences 1981; 26 (7): 55-59
    Contributor: Chris Ball and Musab Hayatli, October 1999
    Reviewer: Lawrence Friedman

    Clinical Question.
    Patient upper gastrointestinal endoscopy
    Intervention or Exposure procedure, endoscopy
    Outcome complications