Endoscopy for overt gastrointestinal bleeding (GIB) in patients with severe thrombocytopenia appears to be safe, with moderate diagnostic and therapeutic yields, according to a retrospective study involving 144 individuals. Participants included inpatients who underwent endoscopy within 24 hours of presenting with overt GIB. Investigators looked at diagnostic and therapeutic yields, adverse events, packed red blood cell (pRBC) and platelet transfusions, recurrent bleeding rate, and all-cause and GIB-related mortality. Among the results:

• Diagnostic yield was 68% (61% for patients with liver cirrhosis and 79% for those with non-liver cirrhosis).
• Therapeutic yield was 60% (59% and 60%, respectively).
• Initial hemostasis rate was 94% with 1 adverse event.
• Median pRBC and platelet transfusions decreased post-intervention.
• Recurrent bleeding rates were 22% at 1 month and 30% at 1 year.
• INR >2 predicted recurrent bleeding.
• All-cause mortality was 19% at 1 month and 37% at 1 year.
• GIB-associated mortality was 3% at 1 month and 4% at 1 year.
• INR >2, activated partial thromboplastin time >38 seconds, hypotension, ICU admission, and pulmonary comorbidities predicted mortality.