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P136 Over-the-scope clips significantly reduce rebleeding and mortality in acute upper GI bleeding (AUGIB): a large propensity score matched cohort study
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P136 Over-the-scope clips significantly reduce rebleeding and mortality in acute upper GI bleeding (AUGIB): a large propensity score matched cohort study
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P136 Over-the-scope clips significantly reduce rebleeding and mortality in acute upper GI bleeding (AUGIB): a large propensity score matched cohort study
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Journal Article
P136 Over-the-scope clips significantly reduce rebleeding and mortality in acute upper GI bleeding (AUGIB): a large propensity score matched cohort study
2025
Overview
IntroductionAcute upper gastrointestinal bleeding (AUGIB) remains a critical medical emergency with high mortality rates. This study investigated the impact of over-the-scope clips (OTSC) on rebleeding and mortality rates in AUGIB compared to conventional endoscopic treatment.MethodsA prospective database was used to identify patients treated with OTSC for AUGIB at a tertiary care university hospital. A propensity score-matched cohort was created from patients treated with conventional endoscopic therapies. Patient demographics, lesion characteristics, and Forrest classification were recorded. Outcomes were compared between groups, focusing on 7- and 30-day rebleeding rates and 30-day mortality. A post-hoc analysis examined the relationship between OTSC deployment position and rebleeding risk.ResultsThe study included 1,023 AUGIB episodes over 5 years, with 112 high-risk lesions treated with OTSC and 109 matched controls treated with conventional therapy. Lesions were predominantly located in the duodenum (71%), followed by the stomach (21%) and esophagus (8%). Peptic ulcers were the most common cause (81.5%). Forrest classifications were distributed as 1a (18%), 1b (27%), 2a (32%), and 2b (23%).OTSC treatment significantly reduced 7-day (3.1% vs 19.7%, p<0.01) and 30-day (6.8% vs 25.5%, p<0.01) rebleeding rates compared to conventional therapy. Haemorrhage-related mortality was also significantly lower in the OTSC group (1.3% vs 4.9%, p=0.02). Post-hoc analysis revealed that visible clip teeth after deployment were associated with increased rebleeding risk (OR 6.8, p<0.01).ConclusionEndoscopic treatment using over-the-scope clips significantly reduces rebleeding and mortality rates in acute upper GI bleeding, demonstrating superior efficacy compared to conventional endoscopic therapies. Large-scale multicentre studies are needed to further confirm the impact of using OTSC on outcomes in AUGIB.
Publisher
BMJ Publishing Group LTD
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