Association of endoscopic intervention with mortality in gastrointestinal bleeding after open-heart surgery: a propensity-score cohort study

Introduction: Postoperative gastrointestinal bleeding (GIB) after open-heart surgery is associated with increased mortality, yet the prognostic impact of endoscopic intervention remains uncertain. Methods: We conducted a single-center retrospective cohort study of adults who developed GIB within 30 days after open-heart surgery (2017-2024). Patients were categorized into endoscopy and non-endoscopy groups, and propensity-score full matching was used to balance baseline covariates. The primary outcome was 30-day all-cause mortality; secondary outcomes were 1-year all-cause mortality, major postbleeding in-hospital complications (including acute myocardial infarction, acute respiratory distress syndrome, and other serious postoperative events), and postbleeding hospital length of stay. Results: = 0.005). Discussion: Among clinically eligible patients with postoperative GIB after open-heart surgery, lower 30-day and 1-year mortality rates were observed in those undergoing endoscopic intervention, whereas no statistically significant differences were observed in major postbleeding in-hospital complications or hospital length of stay. Given the retrospective nature of the study, these results should be considered hypothesis-generating rather than confirmatory, serving as a basis for future prospective investigations.