Background: Initial management of acute upper gastrointestinal bleeding (UGIB) aims towards aggressive fluid resuscitation to maintain hemodynamic stability. Existing evidence regarding benefit of early endoscopy is unclear with some studies suggesting mortality benefits and some suggesting otherwise. The purpose of this study is to evaluate if there is any mortality benefit of doing early endoscopy [...]

Background: Patients with COVID-19 have increased rates of venous thromboembolism, however, there is currently no standardized approach to anticoagulation (AC) therapy particularly with respect to the proper dose of anticoagulation (prophylactic or therapeutic). Many observational studies have shown a mortality benefit in using prophylactic AC for hospitalized patients with COVID-19. A few studies have reported [...]

Background: Esophageal varices with bleeding (EVB) are one of the most common causes of deaths in cirrhotic patients in the United States. Over the course of years, studies have reported an increase in the incidence of EVB and is associated with a high risk for morbidity and mortality. Data is lacking with regards to recent [...]

Background: Epidemiology of Non-Variceal Upper Gastrointestinal Bleeding (NVUGIB) such as peptic ulcer bleeding, Mallory-Weiss tear, erosive gastritis/duodenitis, oesophagitis/oesophageal ulcer is well known among general population. However, data is lacking about its trend among Cirrhotic population in literature. No large database study is available to compare prevalence, predictors, and outcomes of NVUGIB among Cirrhotic patients. We [...]

Background: The risk of thrombosis and bleeding in hospitalized patients with Coronavirus disease 2019 (COVID-19) is uncertain. Early studies suggested patients with COVID-19 may develop a unique coagulopathy marked by elevated thrombotic risk which has led some institutions to recommend stronger thromboprophylaxis in these patients. Our goal was to quantify the incidence of thrombosis and [...]

Background: Guidelines recommend pharmacologic venous thromboembolism (VTE) prophylaxis for high risk hospitalized medical patients that do not have an elevated bleeding risk.  A systematic review of randomized trials estimates the overall bleeding risk with pharmacologic prophylaxis to be low, at 1/1000 (0.1%).  However, it is unclear if the bleeding events were related to pharmacologic prophylaxis [...]

Background: Prophylactic anticoagulation is effective at reducing the risk of venous thromboembolism (VTE), but can also increase the risk of bleeding. Whether anticoagulant prophylaxis should be modified for underweight patients to minimize bleeding complications is unknown.  We sought to determine whether being underweight is associated with the risk of major bleeding in hospitalized medical patients [...]

Background: Over the last two decades concerns have been raised about the potential risk of blood transfusion over the benefits. General restrictive red blood cell (RBC) transfusion approach for anemic hospitalized patients (thresh hold of 7 gm %) has been adopted by American hematology society (AHS) in 2012. It is important to recognize that guidelines [...]

Background: A higher Helicobacter pylori (H. pylori) prevalence was associated with increased rates of post-operative complications including increased marginal ulceration and leak rates. Limited studies described prevalence of H. pylori in patients undergoing bariatric surgery and H. pylori associated upper and lower gastrointestinal bleeding (GIB). Primary Aim of our study was to evaluate the prevalence [...]

Background: Oral anticoagulation is effective for reduction of risk for stroke and systemic embolism in patients with nonvalvular atrial fibrillation, but there may be uncertainty about how to manage anticoagulation in and following an emergency procedure or after treatment of hemorrhage. In case of an emergency, anticoagulation would ideally be immediately and completely reversed, bringing [...]