Because substantial resources are expended treating bleeding recurrences, routine administration of
iv PPI may be an economically advantageous strategy for managing UGI bleeding. A recent review has
examined the cost-effectiveness of detecting the
underlying cause of the bleed and using maintenance strategies for preventing recurrences [30].
However, the cost implications of iv PPI use have
not been evaluated in a setting where UGI bleeds
require immediate treatment at the ED. Thus, the
objective of this study was to investigate whether
the up-front cost of initiating iv PPI before endoscopy in adults presenting to the ED with symptoms
of UGI bleeding would be offset by lower downstream costs from reductions in hospital admissions
and procedures for those with confirmed peptic
ulcer bleeding.