title: Impact of nasogastric lavage on outcomes in acute GI bleeding.
abstract: BACKGROUND
  Nasogastric lavage (NGL) is often performed early in the management of GI bleeding. This practice assumes that NGL results can assist with timely risk stratification and management.
  
  
  OBJECTIVE
  We performed a retrospective analysis to test whether NGL is associated with improved process measures and outcomes in GI bleeding.
  
  
  METHODS
  Propensity-matched retrospective analysis.
  
  
  METHODS
  University-based Veterans Affairs medical center.
  
  
  METHODS
  A total of 632 patients admitted with GI bleeding.
  
  
  METHODS
  Thirty-day mortality rate, length of hospital stay, transfusion requirements, surgery, and time to endoscopy.
  
  
  RESULTS
  Patients receiving NGL were more likely to take nonsteroidal anti-inflammatory drugs and be admitted to intensive care, but less likely to have metastatic disease or tachycardia, be taking warfarin, or present on weekdays. After propensity matching, NGL did not affect mortality (odds ratio [OR] 0.84; 95% confidence interval [CI], 0.37-1.92), length of hospital stay (7.3 vs 8.1 days, P = .57), surgery (OR 1.51; 95% CI, 0.42-5.43), or transfusions (3.2 vs 3.0 units, P = .94). However, NGL was associated with earlier time to endoscopy (hazard ratio 1.49; 95% CI, 1.09-2.04), and bloody aspirates were associated high-risk lesions (OR 2.69; 95% CI, 1.08-6.73).
  
  
  CONCLUSIONS
  Retrospective design.
  
  
  CONCLUSIONS
  Performing NGL is associated with the earlier performance of endoscopy, but does not affect clinical outcomes. Performing NGL at initial triage may promote more timely process of care, but further studies will be needed to confirm these findings.
authors: Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors: Edward S
authors: ES
authors: Huang
authors: Sundip
authors: S
authors: Karsan
authors: Fasiha
authors: F
authors: Kanwal
authors: Inder
authors: I
authors: Singh
authors: Marc
authors: M
authors: Makhani
authors: Brennan M
authors: BM
authors: Spiegel
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001803:Blood Transfusion / Q000706:statistics & numerical data; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005751:Gastric Lavage; D005766:Gastrointestinal Contents; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D057216:Propensity Score; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal