Evidence-based On-call

Upper gastrointestinal bleed

Therapy

Order an endoscopy ^a urgently ^a

to control bleeding ^a

Why?

Patients with acute non-variceal upper GI bleeding who have endoscopic therapy are less likely to rebleed, require surgery or die. ^a
Endoscopic ligation ^a or sclerotherapy ^a reduce rebleeding and death in patients with bleeding oesophageal varices.

Endoscopic therapy reduces rebleeding, surgery and death

Patient	Treatment	Comparison	Outcome	CER	OR (95% CI)	NNT (95% CI)
non-variceal upper GI bleed ^a	endoscopic therapy	no endoscopic therapy	further bleeding	39%	0.38 (0.32 to 0.45)	5 (5 to 6)
			surgery	26%	0.36 (0.28 to 0.45)	7 (6 to 8)
			death	9.9%	0.55 (0.40 to 0.76)	24 (18 to 46)