{
  "abstract": "Background/Objectives: Guidelines recommend endoscopy within 24 h in acute upper gastrointestinal bleeding, but observational studies are confounded by indication. We used the weekday endoscopy schedule of our centre as a natural experiment. Methods: We studied a retrospective cohort of adults undergoing endoscopy for non-variceal upper gastrointestinal bleeding at one tertiary emergency department from 2019 to 2025. Timing was urgent (<12 h), early (12 to 24 h) or elective (>24 h); the primary outcome was 30-day mortality. Friday or Saturday arrival served as an instrument for delay, and crude, multivariable, propensity-based and instrumental-variable estimates were compared. Results: Among 413 episodes in 387 patients, median time to endoscopy was 22.1 h, with 54.5% within 24 h. The groups did not differ on 24 recorded baseline variables or six risk scores. Thirty-day mortality was 5.3% (22 deaths), with no detectable difference by timing (4.2%, 3.9%, and 6.9%; p = 0.420; adjusted odds ratio, elective versus early: 1.42, 95% CI: 0.50 to 4.03). Rebleeding, repeat endoscopy, intensive care admission and a composite outcome were unrelated. Total stay was longer with delay (incidence rate ratio: 1.40, 95% CI: 1.14 to 1.73), while stay from endoscopy onward was not (1.05, 95% CI: 0.80 to 1.38), and each day of waiting added 1.03 days of admission (95% CI: 0.60 to 1.46). Friday or Saturday arrival raised the elective proportion from 33.7% to 87.8% without altering the measured severity. Conclusions: Delay beyond 24 h was associated with no detectable difference in outcomes, although the 22 deaths left a moderate effect possible. The additional bed-days equalled the wait itself, which arose after gastroenterology consultation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Emergency Medicine, Faculty of Medicine, Bolu Abant İzzet Baysal University, 14030 Bolu, Türkiye",
    "Department of Emergency Medicine, Bolu İzzet Baysal Training and Research Hospital, 14030 Bolu, Türkiye"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Lokman Bayram"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Faruk Danış",
      "orcid": "0000-0001-8722-5402"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/86srbnd2acdmy.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15207820",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705092/?tool=EBI",
  "id": "86srbnd2acdmy",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/7820",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2715|Gastrointestinal Bleeding Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7221314102",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13705092/pdf/?tool=EBI",
  "pmcid": "PMC13705092",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/86srbnd2acdmy.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:00Z",
      "native_id": "10.3390/jcm15207820",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/7820"
    },
    {
      "first_seen": "2026-10-30T12:21:49Z",
      "native_id": "PMC:PMC13705092",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13705092"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2715|Gastrointestinal Bleeding Diagnosis and Treatment",
      "subfield": "general"
    }
  ],
  "title": "Day of Arrival as a Determinant of Endoscopy Timing in Non-Variceal Upper Gastrointestinal Bleeding: A Natural-Experiment Cohort Study of Clinical Outcomes and Length of Stay",
  "title_text": "Day of Arrival as a Determinant of Endoscopy Timing in Non-Variceal Upper Gastrointestinal Bleeding: A Natural-Experiment Cohort Study of Clinical Outcomes and Length of Stay",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:49Z",
  "url": "https://research.draconitic.com/paper/86srbnd2acdmy",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}