Advancing hemostasis: A meta-analysis of novel vs conventional endoscopic therapies for non variceal upper gastrointestinal bleeding

Table 3 Subgroup analysis comparing outcomes of over-the-scope clip therapy vs conventional therapy across different bleeding etiologies

Subgroup	Outcome	Pooled RR (OTSC/CT)	95%CI	P value
Peptic ulcer	30-day rebleeding	0.404	0.292-0.559	0.0001
	Short-term rebleeding	0.434	0.286-0.66	0.0001
	Initial hemostasis	1.016	0.998-1.034	0.0774
	Surgical/TAE necessity	1.122	0.603-2.087	0.7171
	30-day mortality	0.844	0.506-1.406	0.5138
	Bleeding mortality	0.741	0.14-3.922	0.7241
Tumor	30-day rebleeding	0.581	0.322-1.05	0.0719
	Short-term rebleeding	0.47	0.237-0.934	0.0312
	Initial hemostasis	1.04	0.987-1.095	0.1447
	Surgical/TAE necessity	0.697	0.228-2.13	0.5263
	30-day mortality	0.361	0.173-0.753	0.0066
	Bleeding mortality	0.163	0.019-1.383	0.0964
Other	30-day rebleeding	0.5	0.315-0.792	0.0032
	Short-term rebleeding	0.635	0.336-1.201	0.1628
	Initial hemostasis	1.033	0.966-1.105	0.34
	Surgical/TAE necessity	2.154	0.833-5.57	0.1136
	30-day mortality	1.147	0.568-2.314	0.7021
	Bleeding mortality	1.0	0.02-49.913	1.0

Pooled risk ratios with 95%CI and P values are presented for each outcome, stratified by etiology: Peptic ulcer, tumor, and other causes. In peptic ulcer bleeding, Over-the-scope clips (OTSC) significantly reduced both 30-day and short-term rebleeding rates, with no significant difference in initial hemostasis, need for surgical or transarterial embolization, or mortality outcomes. In tumor-related bleeding, OTSC was associated with a significant reduction in short-term rebleeding and 30-day mortality, while other outcomes showed no statistically significant differences. In bleeding from other causes, OTSC significantly reduced 30-day rebleeding but did not significantly affect other outcomes. OTSC: Over-the-scope clips; CT: Computed tomography; RR: Relative risk; TAE: Transarterial embolization.