xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT05979025</url>
    </required_header>
    <id_info>
      <org_study_id>AnkaraCHBilkent-NA-TEZ</org_study_id>
      <nct_id>NCT05979025</nct_id>
    </id_info>
    <brief_title>Factors Predicting the Need for Endoscopic Intervention in Non-variceal Upper Gastrointestinal Bleeding</brief_title>
    <official_title>Factors Predicting the Need for Endoscopic Intervention in Non-variceal Upper Gastrointestinal Bleeding</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>Ankara City Hospital Bilkent</agency>
        <agency_class>Other</agency_class>
      </lead_sponsor>
    </sponsors>
    <source>Ankara City Hospital Bilkent</source>
    <oversight_info>
      <has_dmc>No</has_dmc>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>No</is_fda_regulated_device>
    </oversight_info>
    <brief_summary>
      <textblock>
        Gastrointestinal system bleedings are medical emergencies and the most common cause of&#xD;
        hospital admissions related to digestive system diseases. Gastrointestinal system bleedings&#xD;
        are a frequently encountered condition and one of the significant reasons leading to&#xD;
        morbidity, mortality, and medical care costs. For acute upper gastrointestinal system&#xD;
        bleedings, the annual hospital admission incidence in the United States is approximately 67&#xD;
        per 100,000 adults, making it more common than lower gastrointestinal system bleedings.&#xD;
        Approximately 80% of acute upper gastrointestinal system bleedings are attributed to&#xD;
        non-variceal causes. Endoscopy is an invasive procedure used for diagnosis and treatment in&#xD;
        upper gastrointestinal system bleedings. . In recent years, there has been an increase in&#xD;
        endoscopy and endoscopic treatment rates. Except for variceal bleedings, most upper&#xD;
        gastrointestinal system bleedings stop without the need for endoscopic intervention. However,&#xD;
        some patients require endoscopic intervention and identifying this high-risk group, prone to&#xD;
        recurrent bleeding, through non-invasive tests is crucial. In investigators' prospective&#xD;
        study, researcher aimed to facilitate the identification of patients who require intervention&#xD;
        and undergo endoscopic intervention (e.g., epinephrine injection, hemoclips, thermal&#xD;
        coagulation, argon plasma coagulation, etc.) among those who underwent endoscopy within the&#xD;
        first 24 hours after admission to the hospital's emergency department with a diagnosis of&#xD;
        non-variceal acute upper gastrointestinal system bleeding. Investigators sought to achieve&#xD;
        this by determining the relevant parameters related to their clinical and laboratory&#xD;
        findings, comorbidities, and demographic characteristics at the time of admission. This&#xD;
        approach aims to reduce hospital admissions, hospital stay, and costs, and particularly to&#xD;
        minimize interventional procedures during seizures and decrease complications.As of August&#xD;
        2022, patients who applied to the Ankara Bilkent City Hospital emergency department were&#xD;
        followed up.&#xD;
      </textblock>
    </brief_summary>
    <detailed_description>
      <textblock>
        Gastrointestinal system bleedings are medical emergencies and the most common cause of&#xD;
        hospital admissions related to digestive system diseases. Gastrointestinal system bleedings&#xD;
        are a frequently encountered condition and one of the significant reasons leading to&#xD;
        morbidity, mortality, and medical care costs. For acute upper gastrointestinal system&#xD;
        bleedings, the annual hospital admission incidence in the United States is approximately 67&#xD;
        per 100,000 adults, making it more common than lower gastrointestinal system bleedings. A&#xD;
        decrease in the incidence of non-variceal acute upper gastrointestinal system bleeding has&#xD;
        been observed compared to previous years, which is believed to be associated with an increase&#xD;
        in the use of proton pump inhibitors (PPIs), eradication of Helicobacter pylori (H. pylori),&#xD;
        and advancements in endoscopic treatment. Approximately 80% of acute upper gastrointestinal&#xD;
        system bleedings are attributed to non-variceal causes.&#xD;
  &#xD;
        Endoscopy is an invasive procedure used for diagnosis and treatment in upper gastrointestinal&#xD;
        system bleedings. In recent years, there has been an increase in endoscopy and endoscopic&#xD;
        treatment rates. Previous studies have identified higher mortality rates, around 5-10% for&#xD;
        bleeding due to peptic ulcers, and approximately 15% for esophageal variceal bleedings. The&#xD;
        development of modern endoscopy has led to significant advancements in various therapeutic&#xD;
        techniques. Mortality related to all causes of upper gastrointestinal system bleedings has&#xD;
        declined due to advancements in treatment. In recent years, there has been a decrease in&#xD;
        hospitalization duration and mortality, but the total economic burden has significantly&#xD;
        increased.&#xD;
  &#xD;
        Except for variceal bleedings, most upper gastrointestinal system bleedings stop without the&#xD;
        need for endoscopic intervention. However, some patients require endoscopic intervention and&#xD;
        identifying this high-risk group, prone to recurrent bleeding, through non-invasive tests is&#xD;
        crucial. In cases where endoscopic treatment is insufficient, surgical or interventional&#xD;
        radiology procedures such as embolization may be necessary. Endoscopic treatment has led to a&#xD;
        reduction in the need for surgery and blood transfusions in patients presenting with upper&#xD;
        gastrointestinal system bleeding. The goal of treatment is to prevent complications and&#xD;
        deaths. Determining the need for treatment for a patient is clinically and practically easier&#xD;
        than predicting who will die or re-bleed.&#xD;
  &#xD;
        Gastrointestinal bleedings can lead to various clinical scenarios due to multiple lesion&#xD;
        types, and they can occur from any part of the gastrointestinal system, either overtly or&#xD;
        covertly. Upper gastrointestinal bleedings are approximately 5 times more common than lower&#xD;
        gastrointestinal bleedings. Several scoring systems, such as Glasgow-Blatchford, Rockall,&#xD;
        AIMS65, have been developed to predict the need for endoscopic intervention, risk of&#xD;
        re-bleeding, and 30-day mortality in non-variceal bleedings.&#xD;
  &#xD;
        Emergency upper gastrointestinal endoscopy is performed within the first 12 hours in&#xD;
        high-risk patients who present to the hospital's emergency department with acute upper&#xD;
        gastrointestinal system bleeding. However, it may not always be feasible to adhere to this&#xD;
        timeframe, and endoscopy can be performed up to 24 hours after appropriate resuscitation,&#xD;
        depending on the expertise of the personnel.&#xD;
  &#xD;
        In investigators' prospective study, researcher aimed to facilitate the identification of&#xD;
        patients who require intervention and undergo endoscopic intervention (e.g., epinephrine&#xD;
        injection, hemoclips, thermal coagulation, argon plasma coagulation, etc.) among those who&#xD;
        underwent endoscopy within the first 24 hours after admission to the hospital's emergency&#xD;
        department with a diagnosis of non-variceal acute upper gastrointestinal system bleeding.&#xD;
        Investigators sought to achieve this by determining the relevant parameters related to their&#xD;
        clinical and laboratory findings, comorbidities, and demographic characteristics at the time&#xD;
        of admission. This approach aims to reduce hospital admissions, hospital stay, and costs, and&#xD;
        particularly to minimize interventional procedures during seizures and decrease&#xD;
        complications. As of August 2022, patients who applied to the Ankara Bilkent City Hospital&#xD;
        emergency department were followed up.&#xD;
      </textblock>
    </detailed_description>
    <overall_status>Completed</overall_status>
    <start_date type="Actual">August 11, 2022</start_date>
    <completion_date type="Actual">September 7, 2023</completion_date>
    <primary_completion_date type="Actual">July 29, 2023</primary_completion_date>
    <study_type>Observational</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <observational_model>Cohort</observational_model>
      <time_perspective>Prospective</time_perspective>
    </study_design_info>
    <primary_outcome>
      <measure>Endoscopic intervention</measure>
      <time_frame>First 24 hours after hospital admission</time_frame>
      <description>Mechanical treatment (eg hemoclips, tape, etc.), injection therapy (eg epinephrine etc.), thermal coagulation (eg heater probe etc.)</description>
    </primary_outcome>
    <secondary_outcome>
      <measure>İntensive care hospitalization</measure>
      <time_frame>30 days after admission to hospital</time_frame>
      <description>Intensive care unit (ICU) admission of patients presenting to the hospital due to non-variceal upper gastrointestinal system bleeding either at the time of admission or within 30 days after hospitalization for any reason.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Mortality</measure>
      <time_frame>30 days after admission to hospital</time_frame>
      <description>Death within 30 days of hospital admission with non-variceal upper gastrointestinal bleeding</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Rebleeding</measure>
      <time_frame>30 days after admission to hospital</time_frame>
      <description>Rebleeding within 30 days of hospital admission with non-variceal upper gastrointestinal bleeding</description>
    </secondary_outcome>
    <enrollment type="Actual">262</enrollment>
    <condition>Acute Upper Gastrointestinal Bleeding</condition>
    <eligibility>
      <study_pop>
        <textblock>
          Patients who are 18 years of age and older and present to our hospital with a diagnosis of&#xD;
          non-variceal upper gastrointestinal bleeding, among whom endoscopy is performed within the&#xD;
          first 24 hours after hospital admission&#xD;
        </textblock>
      </study_pop>
      <sampling_method>Non-Probability Sample</sampling_method>
      <criteria>
        <textblock>
          Inclusion Criteria:&#xD;
  &#xD;
            -  Patients who present to our hospital with a diagnosis of non-variceal upper&#xD;
               gastrointestinal bleeding&#xD;
  &#xD;
            -  Patients who undergo endoscopy within the first 24 hours after hospital admission&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
            -  Patients who have variceal bleeding&#xD;
  &#xD;
            -  Lower gastrointestinal system bleeding&#xD;
  &#xD;
            -  Individuals who are under the age of 18&#xD;
  &#xD;
            -  Patients who do not undergo endoscopy within the first 24 hours after hospital&#xD;
               admission&#xD;
        </textblock>
      </criteria>
      <gender>All</gender>
      <minimum_age>18 Years</minimum_age>
      <maximum_age>N/A</maximum_age>
      <healthy_volunteers>No</healthy_volunteers>
    </eligibility>
    <location>
      <facility>
        <name>Ankara Bilkent City Hospital</name>
        <address>
          <city>Ankara</city>
          <country>Turkey</country>
        </address>
      </facility>
    </location>
    <location_countries>
      <country>Turkey</country>
    </location_countries>
    <results_reference>
      <citation>Wuerth BA, Rockey DC. Changing Epidemiology of Upper Gastrointestinal Hemorrhage in the Last Decade: A Nationwide Analysis. Dig Dis Sci. 2018 May;63(5):1286-1293. doi: 10.1007/s10620-017-4882-6. Epub 2017 Dec 27.</citation>
      <PMID>29282637</PMID>
    </results_reference>
    <results_reference>
      <citation>Abougergi MS, Travis AC, Saltzman JR. The in-hospital mortality rate for upper GI hemorrhage has decreased over 2 decades in the United States: a nationwide analysis. Gastrointest Endosc. 2015 Apr;81(4):882-8.e1. doi: 10.1016/j.gie.2014.09.027. Epub 2014 Dec 5.</citation>
      <PMID>25484324</PMID>
    </results_reference>
    <results_reference>
      <citation>Masaoka T, Suzuki H, Hori S, Aikawa N, Hibi T. Blatchford scoring system is a useful scoring system for detecting patients with upper gastrointestinal bleeding who do not need endoscopic intervention. J Gastroenterol Hepatol. 2007 Sep;22(9):1404-8. doi: 10.1111/j.1440-1746.2006.04762.x.</citation>
      <PMID>17716345</PMID>
    </results_reference>
    <results_reference>
      <citation>Chen IC, Hung MS, Chiu TF, Chen JC, Hsiao CT. Risk scoring systems to predict need for clinical intervention for patients with nonvariceal upper gastrointestinal tract bleeding. Am J Emerg Med. 2007 Sep;25(7):774-9. doi: 10.1016/j.ajem.2006.12.024.</citation>
      <PMID>17870480</PMID>
    </results_reference>
    <results_reference>
      <citation>Lanas A, Dumonceau JM, Hunt RH, Fujishiro M, Scheiman JM, Gralnek IM, Campbell HE, Rostom A, Villanueva C, Sung JJY. Non-variceal upper gastrointestinal bleeding. Nat Rev Dis Primers. 2018 Apr 19;4:18020. doi: 10.1038/nrdp.2018.20.</citation>
      <PMID>29671413</PMID>
    </results_reference>
    <results_reference>
      <citation>Kamboj AK, Hoversten P, Leggett CL. Upper Gastrointestinal Bleeding: Etiologies and Management. Mayo Clin Proc. 2019 Apr;94(4):697-703. doi: 10.1016/j.mayocp.2019.01.022.</citation>
      <PMID>30947833</PMID>
    </results_reference>
    <results_reference>
      <citation>Wilkins T, Wheeler B, Carpenter M. Upper Gastrointestinal Bleeding in Adults: Evaluation and Management. Am Fam Physician. 2020 Mar 1;101(5):294-300. Erratum In: Am Fam Physician. 2021 Jan 15;103(2):70.</citation>
      <PMID>32109037</PMID>
    </results_reference>
    <results_reference>
      <citation>Rockey DC. Gastrointestinal bleeding. Gastroenterol Clin North Am. 2005 Dec;34(4):581-8. doi: 10.1016/j.gtc.2005.08.002.</citation>
      <PMID>16303571</PMID>
    </results_reference>
    <results_reference>
      <citation>Lakatos L, Gonczi L, Lontai L, Izbeki F, Patai A, Racz I, Gasztonyi B, Varga-Szabo L, Ilias A, Lakatos PL. Incidence, Predictive Factors, Clinical Characteristics and Outcome of Non-variceal Upper Gastrointestinal Bleeding - A Prospective Population-based Study from Hungary. J Gastrointestin Liver Dis. 2021 Sep 21;30(3):327-333. doi: 10.15403/jgld-3495.</citation>
      <PMID>34375379</PMID>
    </results_reference>
    <verification_date>September 2023</verification_date>
    <study_first_submitted>July 30, 2023</study_first_submitted>
    <study_first_submitted_qc>July 30, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">August 7, 2023</study_first_posted>
    <last_update_submitted>September 7, 2023</last_update_submitted>
    <last_update_submitted_qc>September 7, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">September 8, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Principal Investigator</responsible_party_type>
      <investigator_affiliation>Ankara City Hospital Bilkent</investigator_affiliation>
      <investigator_full_name>numanaydin</investigator_full_name>
      <investigator_title>Medical Doctor</investigator_title>
    </responsible_party>
    <condition_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Gastrointestinal Hemorrhage</mesh_term>
      <mesh_term>Hemorrhage</mesh_term>
    </condition_browse>
    <patient_data>
      <sharing_ipd>Undecided</sharing_ipd>
    </patient_data>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT05979025
  org study id: AnkaraCHBilkent-NA-TEZ
  nct id: NCT05979025
  lead sponsor: 
  has dmc: No
  is fda regulated drug: No
  is fda regulated device: No
  Gastrointestinal system bleedings are medical emergencies and the most common cause of
        hospital admissions related to digestive system diseases. Gastrointestinal system bleedings
        are a frequently encountered condition and one of the significant reasons leading to
        morbidity, mortality, and medical care costs. For acute upper gastrointestinal system
        bleedings, the annual hospital admission incidence in the United States is approximately 67
        per 100,000 adults, making it more common than lower gastrointestinal system bleedings.
        Approximately 80% of acute upper gastrointestinal system bleedings are attributed to
        non-variceal causes. Endoscopy is an invasive procedure used for diagnosis and treatment in
        upper gastrointestinal system bleedings. . In recent years, there has been an increase in
        endoscopy and endoscopic treatment rates. Except for variceal bleedings, most upper
        gastrointestinal system bleedings stop without the need for endoscopic intervention. However,
        some patients require endoscopic intervention and identifying this high-risk group, prone to
        recurrent bleeding, through non-invasive tests is crucial. In investigators' prospective
        study, researcher aimed to facilitate the identification of patients who require intervention
        and undergo endoscopic intervention (e.g., epinephrine injection, hemoclips, thermal
        coagulation, argon plasma coagulation, etc.) among those who underwent endoscopy within the
        first 24 hours after admission to the hospital's emergency department with a diagnosis of
        non-variceal acute upper gastrointestinal system bleeding. Investigators sought to achieve
        this by determining the relevant parameters related to their clinical and laboratory
        findings, comorbidities, and demographic characteristics at the time of admission. This
        approach aims to reduce hospital admissions, hospital stay, and costs, and particularly to
        minimize interventional procedures during seizures and decrease complications.As of August
        2022, patients who applied to the Ankara Bilkent City Hospital emergency department were
        followed up.
  Gastrointestinal system bleedings are medical emergencies and the most common cause of
        hospital admissions related to digestive system diseases. Gastrointestinal system bleedings
        are a frequently encountered condition and one of the significant reasons leading to
        morbidity, mortality, and medical care costs. For acute upper gastrointestinal system
        bleedings, the annual hospital admission incidence in the United States is approximately 67
        per 100,000 adults, making it more common than lower gastrointestinal system bleedings. A
        decrease in the incidence of non-variceal acute upper gastrointestinal system bleeding has
        been observed compared to previous years, which is believed to be associated with an increase
        in the use of proton pump inhibitors (PPIs), eradication of Helicobacter pylori (H. pylori),
        and advancements in endoscopic treatment. Approximately 80% of acute upper gastrointestinal
        system bleedings are attributed to non-variceal causes.
  
        Endoscopy is an invasive procedure used for diagnosis and treatment in upper gastrointestinal
        system bleedings. In recent years, there has been an increase in endoscopy and endoscopic
        treatment rates. Previous studies have identified higher mortality rates, around 5-10% for
        bleeding due to peptic ulcers, and approximately 15% for esophageal variceal bleedings. The
        development of modern endoscopy has led to significant advancements in various therapeutic
        techniques. Mortality related to all causes of upper gastrointestinal system bleedings has
        declined due to advancements in treatment. In recent years, there has been a decrease in
        hospitalization duration and mortality, but the total economic burden has significantly
        increased.
  
        Except for variceal bleedings, most upper gastrointestinal system bleedings stop without the
        need for endoscopic intervention. However, some patients require endoscopic intervention and
        identifying this high-risk group, prone to recurrent bleeding, through non-invasive tests is
        crucial. In cases where endoscopic treatment is insufficient, surgical or interventional
        radiology procedures such as embolization may be necessary. Endoscopic treatment has led to a
        reduction in the need for surgery and blood transfusions in patients presenting with upper
        gastrointestinal system bleeding. The goal of treatment is to prevent complications and
        deaths. Determining the need for treatment for a patient is clinically and practically easier
        than predicting who will die or re-bleed.
  
        Gastrointestinal bleedings can lead to various clinical scenarios due to multiple lesion
        types, and they can occur from any part of the gastrointestinal system, either overtly or
        covertly. Upper gastrointestinal bleedings are approximately 5 times more common than lower
        gastrointestinal bleedings. Several scoring systems, such as Glasgow-Blatchford, Rockall,
        AIMS65, have been developed to predict the need for endoscopic intervention, risk of
        re-bleeding, and 30-day mortality in non-variceal bleedings.
  
        Emergency upper gastrointestinal endoscopy is performed within the first 12 hours in
        high-risk patients who present to the hospital's emergency department with acute upper
        gastrointestinal system bleeding. However, it may not always be feasible to adhere to this
        timeframe, and endoscopy can be performed up to 24 hours after appropriate resuscitation,
        depending on the expertise of the personnel.
  
        In investigators' prospective study, researcher aimed to facilitate the identification of
        patients who require intervention and undergo endoscopic intervention (e.g., epinephrine
        injection, hemoclips, thermal coagulation, argon plasma coagulation, etc.) among those who
        underwent endoscopy within the first 24 hours after admission to the hospital's emergency
        department with a diagnosis of non-variceal acute upper gastrointestinal system bleeding.
        Investigators sought to achieve this by determining the relevant parameters related to their
        clinical and laboratory findings, comorbidities, and demographic characteristics at the time
        of admission. This approach aims to reduce hospital admissions, hospital stay, and costs, and
        particularly to minimize interventional procedures during seizures and decrease
        complications. As of August 2022, patients who applied to the Ankara Bilkent City Hospital
        emergency department were followed up.
  observational model: Cohort
  time perspective: Prospective
  measure: Endoscopic intervention
  time frame: First 24 hours after hospital admission
  description: Mechanical treatment (eg hemoclips, tape, etc.), injection therapy (eg epinephrine etc.), thermal coagulation (eg heater probe etc.)
  measure: İntensive care hospitalization
  time frame: 30 days after admission to hospital
  description: Intensive care unit (ICU) admission of patients presenting to the hospital due to non-variceal upper gastrointestinal system bleeding either at the time of admission or within 30 days after hospitalization for any reason.
  measure: Mortality
  time frame: 30 days after admission to hospital
  description: Death within 30 days of hospital admission with non-variceal upper gastrointestinal bleeding
  measure: Rebleeding
  time frame: 30 days after admission to hospital
  description: Rebleeding within 30 days of hospital admission with non-variceal upper gastrointestinal bleeding
  study pop: 
  sampling method: Non-Probability Sample
  criteria: 
  gender: All
  minimum age: 18 Years
  maximum age: N/A
  healthy volunteers: No
  facility: 
  country: Turkey
  citation: Wuerth BA, Rockey DC. Changing Epidemiology of Upper Gastrointestinal Hemorrhage in the Last Decade: A Nationwide Analysis. Dig Dis Sci. 2018 May;63(5):1286-1293. doi: 10.1007/s10620-017-4882-6. Epub 2017 Dec 27.
  PMID: 29282637
  citation: Abougergi MS, Travis AC, Saltzman JR. The in-hospital mortality rate for upper GI hemorrhage has decreased over 2 decades in the United States: a nationwide analysis. Gastrointest Endosc. 2015 Apr;81(4):882-8.e1. doi: 10.1016/j.gie.2014.09.027. Epub 2014 Dec 5.
  PMID: 25484324
  citation: Masaoka T, Suzuki H, Hori S, Aikawa N, Hibi T. Blatchford scoring system is a useful scoring system for detecting patients with upper gastrointestinal bleeding who do not need endoscopic intervention. J Gastroenterol Hepatol. 2007 Sep;22(9):1404-8. doi: 10.1111/j.1440-1746.2006.04762.x.
  PMID: 17716345
  citation: Chen IC, Hung MS, Chiu TF, Chen JC, Hsiao CT. Risk scoring systems to predict need for clinical intervention for patients with nonvariceal upper gastrointestinal tract bleeding. Am J Emerg Med. 2007 Sep;25(7):774-9. doi: 10.1016/j.ajem.2006.12.024.
  PMID: 17870480
  citation: Lanas A, Dumonceau JM, Hunt RH, Fujishiro M, Scheiman JM, Gralnek IM, Campbell HE, Rostom A, Villanueva C, Sung JJY. Non-variceal upper gastrointestinal bleeding. Nat Rev Dis Primers. 2018 Apr 19;4:18020. doi: 10.1038/nrdp.2018.20.
  PMID: 29671413
  citation: Kamboj AK, Hoversten P, Leggett CL. Upper Gastrointestinal Bleeding: Etiologies and Management. Mayo Clin Proc. 2019 Apr;94(4):697-703. doi: 10.1016/j.mayocp.2019.01.022.
  PMID: 30947833
  citation: Wilkins T, Wheeler B, Carpenter M. Upper Gastrointestinal Bleeding in Adults: Evaluation and Management. Am Fam Physician. 2020 Mar 1;101(5):294-300. Erratum In: Am Fam Physician. 2021 Jan 15;103(2):70.
  PMID: 32109037
  citation: Rockey DC. Gastrointestinal bleeding. Gastroenterol Clin North Am. 2005 Dec;34(4):581-8. doi: 10.1016/j.gtc.2005.08.002.
  PMID: 16303571
  citation: Lakatos L, Gonczi L, Lontai L, Izbeki F, Patai A, Racz I, Gasztonyi B, Varga-Szabo L, Ilias A, Lakatos PL. Incidence, Predictive Factors, Clinical Characteristics and Outcome of Non-variceal Upper Gastrointestinal Bleeding - A Prospective Population-based Study from Hungary. J Gastrointestin Liver Dis. 2021 Sep 21;30(3):327-333. doi: 10.15403/jgld-3495.
  PMID: 34375379
  responsible party type: Principal Investigator
  investigator affiliation: Ankara City Hospital Bilkent
  investigator full name: numanaydin
  investigator title: Medical Doctor
  mesh term: Gastrointestinal Hemorrhage
  mesh term: Hemorrhage
  sharing ipd: Undecided