Title: Optimal Endoscopy Timing in Elderly Patients Presenting with Acute Non-Variceal
Upper Gastrointestinal Bleeding.
Version: 2 Date: 21 Jul 2024
Reviewer:  Riccardo Marmo
Reviewer's report:
This is a retrospective cohort study including patients with nonvariceal upper gastrointestinal
bleeding (NVUGIB) who were hospitalized in the emergency department of a tertiary referral
center between January 2019 and April 2020
The study aimed to evaluate the optimal endoscopy time in elderly patients based on clinical
outcomes.
The authors considered two groups of patients based on their age,  < 65 vs  #65  years old:
208 (44.4%) were under 65 years of age, 260 (55.6%) were over 65 years of age.
The time to endoscopy was categorized into three groups:
very early  (<12 hours), early   (12-24 hours), and late (>24 hours).
They concluded that early endoscopy may benefit the management of acute UGIB, especially
in the elderly population with high comorbidities and severity of bleeding.
Major point
Please indicate primary and secondary outcomes
Include the sample size needed to reach a scientifically sound conclusion
Please define severe bleeding, this definition is crucial for the possible selection bias process.
The authors stated “Within the first 12 to 48 hours, patients who were clinically stable and had
not experienced severe bleeding underwent an endoscopy”.
The two groups are significantly different for number of patients with comorbidities and
treatment received: these two points “per se  “ impact the outcomes considered.
A multivariate analysis could be useful.
The results and conclusions can vary substantially after the proposed analysis
Title: Optimal Endoscopy Timing in Elderly Patients Presenting with Acute Non-Variceal
Upper Gastrointestinal Bleeding.
Version: 2 Date: 21 Jul 2024
Reviewer:  Riccardo Marmo
Reviewer's report:
This is a retrospective cohort study including patients with nonvariceal upper gastrointestinal
bleeding (NVUGIB) who were hospitalized in the emergency department of a tertiary referral
center between January 2019 and April 2020
The study aimed to evaluate the optimal endoscopy time in elderly patients based on clinical
outcomes.
The authors considered two groups of patients based on their age,  < 65 vs  #65  years old:
208 (44.4%) were under 65 years of age, 260 (55.6%) were over 65 years of age.
The time to endoscopy was categorized into three groups:
very early  (<12 hours), early   (12-24 hours), and late (>24 hours).
They concluded that early endoscopy may benefit the management of acute UGIB, especially
in the elderly population with high comorbidities and severity of bleeding.
Major point
Please indicate primary and secondary outcomes
Include the sample size needed to reach a scientifically sound conclusion
Please define severe bleeding, this definition is crucial for the possible selection bias process.
The authors stated “Within the first 12 to 48 hours, patients who were clinically stable and had
not experienced severe bleeding underwent an endoscopy”.
The two groups are significantly different for number of patients with comorbidities and
treatment received: these two points “per se  “ impact the outcomes considered.
A multivariate analysis could be useful.
The results and conclusions can vary substantially after the proposed analysis
Please review this paper.
user
Title: Optimal Endoscopy Timing in Elderly Patients Presenting with Acute Non-Variceal
Upper Gastrointestinal Bleeding.
Version: 2 Date: 21 Jul 2024
Reviewer:  Riccardo Marmo
Reviewer's report:
This is a retrospective cohort study including patients with nonvariceal upper gastrointestinal
bleeding (NVUGIB) who were hospitalized in the emergency department of a tertiary referral
center between January 2019 and April 2020
The study aimed to evaluate the optimal endoscopy time in elderly patients based on clinical
outcomes.
The authors considered two groups of patients based on their age,  < 65 vs  #65  years old:
208 (44.4%) were under 65 years of age, 260 (55.6%) were over 65 years of age.
The time to endoscopy was categorized into three groups:
very early  (<12 hours), early   (12-24 hours), and late (>24 hours).
They concluded that early endoscopy may benefit the management of acute UGIB, especially
in the elderly population with high comorbidities and severity of bleeding.
Major point
Please indicate primary and secondary outcomes
Include the sample size needed to reach a scientifically sound conclusion
Please define severe bleeding, this definition is crucial for the possible selection bias process.
The authors stated “Within the first 12 to 48 hours, patients who were clinically stable and had
not experienced severe bleeding underwent an endoscopy”.
The two groups are significantly different for number of patients with comorbidities and
treatment received: these two points “per se  “ impact the outcomes considered.
A multivariate analysis could be useful.
The results and conclusions can vary substantially after the proposed analysis
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