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Aim  Urgent endoscopy is essential in gastrointestinal ( GI ) bleeding. Emergency physicians with endoscopy training treat patients with  GI  bleeding in our hospital. We compared the management and clinical outcomes of  GI  bleeding cases between those treated by an emergency physician ( EP ) and those treated by a non‐emergency physician ( NEP ; e.g., gastroenterologist or general surgeon).    Methods  We undertook a retrospective chart review of upper  GI  bleeding cases treated using endoscopy in the emergency department between 2012 and 2014. We examined patients characteristics, endoscopic findings, hemostatic procedures, need for transfusion, rebleeding and adverse events, length of hospital stay, and mortality.    Results  The  EP  group included 33 patients (39%) and the  NEP  group included 51 (61%). Patient characteristics and diseases did not differ between the groups. The  EP  group underwent urgent endoscopy more often (100% versus 86%,  P  = 0.04). Procedure times were not statistically different between the groups. The  EP  group had fewer hemostatic procedures (42% versus 65%,  P  = 0.04). Transfusion requirements were lower in the  EP  group (0.5 U versus 2.1 U,  P  = 0.006). There were no statistical differences in rebleeding and adverse events. The length of hospital stay was shorter (8 versus 11 days,  P  = 0.03) and the in‐hospital mortality rate was lower in the  EP  group (0% versus 13.7%,  P  = 0.04).    Conclusion  Short‐term outcomes in  GI  bleeding cases managed by emergency physicians with endoscopy training were comparable to those by gastroenterologists and general surgeons. However, the extent of endoscopic training and experience emergency physicians should have remains unclear.

acute medicine and surgery

Potential role for emergency physicians with endoscopy training in the treatment of upper gastrointestinal hemorrhage: a retrospective observational study