[Value and economic analysis of emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage].
OBJECTIVE
To study the application value of emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage, and to evaluated by the economic analysis whether the emergency endoscopy was safe and effective,or shorten the hospitalization days and reduced the medical costs.


METHODS
Ninety-one patients with massive upper gastrointestinal hemorrhage were randomly divided into emergency endoscopy group (group A) and non-emergency endoscopy group (group B). The patients in group A underwent endoscopy as soon as the blood pressures were normal and the patients of group B underwent endoscopy at 24-48 hours after hospitalization. They would be treated depending on the conditions by endoscopy. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the endoscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evaluated and the cost-effect ratio (C/E) was calculated.


RESULTS
The correct diagnosis rates and the endoscopy costs of group A were higher than the group B (100.0 percent vs.90.2 percent, P<0.05; (714.78+/-263.54) yuan vs. (383.57+/-251.72) yuan, P<0.01), and the rebleeding rates, the mean hospitalizations days, the blood transfusion costs and the drugs costs and the total hospitalization costs were all lower compared to the group B (6.1 percent vs. 26.8 percent, P<0.05; (5.42+/-1.70) days vs. (8.51+/-2.30) days, P<0.01; (791.80+/-258.35) yuan vs. (1270.29+/-569.21) yuan, P<0.01; (945.22+/-125.82) yuan vs. (1223.81+/-254.44) yuan, P<0.01; (2785.76+/-353.26) yuan vs. (3 527.76+/-555.62)yuan, P<0.01. The C/E of group A was lower than the group B (2785.76 yuan per patient vs. 3527.76 yuan per patient, P<0.01).


CONCLUSIONS
Emergency endoscopy is not only safe and effective but also economical in the diagnosis and treatment of massive upper gastrointestinal hemorrhage.
Gan
Ai-hua
AH
Department of Digestion, Huizhou Municipal Central Hospital, Huizhou 516001, China.
Xu
Au-gao
AG
Ling
Hong
H
Chen
Hui-xin
HX
Zhang
Yu-ming
YM
Tong
Zhi-yong
ZY
Zhong
Xu-hui
XH
Xu
Yong-cheng
YC
D000328:Adult; D003362:Cost-Benefit Analysis; D004630:Emergencies; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000628:therapy*; D005773:Gastroscopy / Q000191:economics*; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged