Randomized Trial of Outpatient vs. Inpatient Management of Low-risk Patients With Upper Gastrointestinal Bleeding.
Primary Purpose
Upper Gastrointestinal Bleeding
Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Outpatient Management of Low-risk Patients
Inpatient Management of Low-risk Patients
Sponsored by
About this trial
This is an interventional treatment trial for Upper Gastrointestinal Bleeding
Eligibility Criteria
Inclusion Criteria:
- Blood Urea Nitrogen < 18.2 mg/dl
- Hemoglobin ≥ 13.0 g/dl for men and ≥ 12.0 g/dl for women
- Systolic blood pressure ≥ 110 mm Hg
- Heart rate < 100 beats/min
Exclusion Criteria:
- Inability to obtain informed consent
- Pregnancy
- History of liver disease
- History of heart failure
- Syncope that is temporally related to ongoing bleeding
- Melena
- Contraindication to proton pump inhibitor use
- Other conditions that necessitate inpatient evaluation.
- Inpatients with new onset of GI bleeding
Sites / Locations
- Yale New Haven Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
Outpatient
Inpatient
Arm Description
Outcomes
Primary Outcome Measures
The number of patients requiring intervention for UGIB (endoscopic therapy, blood transfusion, surgery, interventional radiology)
Secondary Outcome Measures
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02005705
Brief Title
Randomized Trial of Outpatient vs. Inpatient Management of Low-risk Patients With Upper Gastrointestinal Bleeding.
Official Title
Randomized Trial of Outpatient vs. Inpatient Management of Low-risk Patients With Upper Gastrointestinal Bleeding.
Study Type
Interventional
2. Study Status
Record Verification Date
July 2016
Overall Recruitment Status
Terminated
Why Stopped
Inadequate recruitment
Study Start Date
December 2013 (undefined)
Primary Completion Date
June 2016 (Actual)
Study Completion Date
June 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Yale University
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Patients presenting to the emergency room with upper gastrointestinal bleeding and a Glasgow Blatchford score of zero will be randomly assigned to further care in the inpatient vs. outpatient setting. The hypothesis of this study is that patients who are managed as outpatients will require interventions at a rate not higher than those managed as inpatients and will have lower direct healthcare costs.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Upper Gastrointestinal Bleeding
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
17 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Outpatient
Arm Type
Active Comparator
Arm Title
Inpatient
Arm Type
Active Comparator
Intervention Type
Other
Intervention Name(s)
Outpatient Management of Low-risk Patients
Intervention Description
Labs will be obtained within 2-3 days of discharge from ED
Clinic visit will be scheduled within 3 days of discharge from ED
EGD will be scheduled within 7 days of discharge from ED
Phone follow-up at day 7 and 30
Intervention Type
Other
Intervention Name(s)
Inpatient Management of Low-risk Patients
Intervention Description
Labs will be obtained on day of discharge or day 2-3
EGD will be performed in the hospital
Phone follow-up at day 7 and 30
Primary Outcome Measure Information:
Title
The number of patients requiring intervention for UGIB (endoscopic therapy, blood transfusion, surgery, interventional radiology)
Time Frame
Within 7 days of the index presentation to the emergency room
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Blood Urea Nitrogen < 18.2 mg/dl
Hemoglobin ≥ 13.0 g/dl for men and ≥ 12.0 g/dl for women
Systolic blood pressure ≥ 110 mm Hg
Heart rate < 100 beats/min
Exclusion Criteria:
Inability to obtain informed consent
Pregnancy
History of liver disease
History of heart failure
Syncope that is temporally related to ongoing bleeding
Melena
Contraindication to proton pump inhibitor use
Other conditions that necessitate inpatient evaluation.
Inpatients with new onset of GI bleeding
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Loren Laine, MD
Organizational Affiliation
Yale University, Section of Digestive Disease
Official's Role
Principal Investigator
Facility Information:
Facility Name
Yale New Haven Hospital
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Randomized Trial of Outpatient vs. Inpatient Management of Low-risk Patients With Upper Gastrointestinal Bleeding.
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