Study: Tube Placement May Be Unnecessary for Treating Upper GI Bleeds
Feb. 7, 2017
CHARLESTON, SC – A study published in the February issue of General Internal Medicine suggests that for many of the millions of patients treated annually in hospitals for upper gastrointestinal (GI) bleeding, there is little value in placing a nasogastric (NG) tube in patients to determine the source of that bleeding or size of a lesion.
Study authors, including Don Rockey, M.D., Medical of University of South Carolina (MUSC) Department of Medicine chairman and professor of gastroenterology, position the research as improving patient care by doing less when possible, in terms of procedures or treatments that don’t provide significant benefit to patients and are costly and uncomfortable.
“Placing a tube through the nose and down into the stomach makes sense if we are talking about delivering nutrition to a patient or to get an idea of what is in someone’s stomach, but the value of placing this tube for patients who have an upper GI bleed has been unclear,” Rockey said. “Our goal was to examine that value, and our results suggest that for millions of patients with an upper GI bleed, placing this tube had little clinical benefit, and produces unnecessary cost and discomfort for all involved. If it doesn’t help the patient or the clinician trying to diagnose the cause of this kind of bleed, we don’t need it as a standard of care when there is no value.”
The single-blind, randomized, prospective, non-inferiority study compared NG placement (with aspiration and lavage) to no NG placement (control), and demonstrated that NG tube placement in patients with typical upper GI bleeding had no impact on outcomes. In addition, the placement of NG tubes was often unsuccessful or associated with patient discomfort.
Founded in 1824, the Medical University of South Carolina (MUSC) continues the tradition of excellence in education, research and patient care. MUSC educates and trains more than 3,000 students and nearly 800 residents in six colleges and has more than 17,000 employees. As the state’s only integrated academic health sciences center and largest non-federal employer in Charleston, the university and its affiliates have collective annual budgets in excess of $3.2 billion, with an annual economic impact of nearly $4 billion and annual research funding in excess of $284 million.
As the clinical health system of the Medical University of South Carolina, MUSC Health is dedicated to delivering the highest quality patient care available, while training generations of competent, compassionate health care providers to serve the people of South Carolina and beyond. Comprising some 1,600 beds, more than 100 outreach sites, the MUSC College of Medicine, the physicians’ practice plan, and nearly 275 telehealth locations, MUSC Health owns and operates eight hospitals situated in Charleston, Chester, Florence, Lancaster and Marion counties. In 2019, for the fifth consecutive year, U.S. News & World Report named MUSC Health the No. 1 hospital in South Carolina.