BACKGROUND: Practices relating to acute peptic ulcer bleeding (APUB) outside of guideline recommendations are unknown. OBJECTIVE: To evaluate the practices of university-affiliated (UA) versus nonuniversity-affiliated (non-UA) gastroenterologists in controversial APUB issues. METHODS: Gastroenterologists in Canada were mailed an anonymous questionnaire (January 2008) regarding APUB management. RESULTS: Responses were received for 281 of the 530 questionnaires mailed (53%). There were no differences between the UA versus non-UA gastroenterologists regarding acid suppression medication and route of administration pre- and postendoscopy (all P>0.05). There were no differences in endoscopic practices between groups regarding large versus small volume injection, endoclip versus combination injection plus coagulation, endoclip versus endoclip plus injection, and management of adherent clots (all P>0.05). There was variability within each group regarding optimal empirical acid suppression pre- and postendoscopy, volume of injection therapy and endoclip use. The non-UA group had longer delays before restarting acetylsalicyclic acid (P=0.08) and warfarin (P=0.02) post-APUB. CONCLUSIONS: UA and non-UA gastroenterologists have similar practices in acid suppression and endoscopic therapy for controversial APUB issues; however, non-UA gastroenterologists appear more cautious in restarting acetylsalicylic acid and warfarin. Further studies are needed to address the optimal empirical acid suppression pre- and postendoscopy, injection therapy volume, endoclip use, and timing of restarting antiplatelet and anticoagulation therapy.
BACKGROUND: Practices relating to acute peptic ulcer bleeding (APUB) outside of guideline recommendations are unknown. OBJECTIVE: To evaluate the practices of university-affiliated (UA) versus nonuniversity-affiliated (non-UA) gastroenterologists in controversial APUB issues. METHODS: Gastroenterologists in Canada were mailed an anonymous questionnaire (January 2008) regarding APUB management. RESULTS: Responses were received for 281 of the 530 questionnaires mailed (53%). There were no differences between the UA versus non-UA gastroenterologists regarding acid suppression medication and route of administration pre- and postendoscopy (all P>0.05). There were no differences in endoscopic practices between groups regarding large versus small volume injection, endoclip versus combination injection plus coagulation, endoclip versus endoclip plus injection, and management of adherent clots (all P>0.05). There was variability within each group regarding optimal empirical acid suppression pre- and postendoscopy, volume of injection therapy and endoclip use. The non-UA group had longer delays before restarting acetylsalicyclic acid (P=0.08) and warfarin (P=0.02) post-APUB. CONCLUSIONS: UA and non-UA gastroenterologists have similar practices in acid suppression and endoscopic therapy for controversial APUB issues; however, non-UA gastroenterologists appear more cautious in restarting acetylsalicylic acid and warfarin. Further studies are needed to address the optimal empirical acid suppression pre- and postendoscopy, injection therapy volume, endoclip use, and timing of restarting antiplatelet and anticoagulation therapy.
Authors: J Y Lau; J J Sung; K K Lee; M Y Yung; S K Wong; J C Wu; F K Chan; E K Ng; J H You; C W Lee; A C Chan; S C Chung Journal: N Engl J Med Date: 2000-08-03 Impact factor: 91.245
Authors: Alan Barkun; Carlo A Fallone; Naoki Chiba; Marty Fishman; Nigel Flook; Janet Martin; Alaa Rostom; Anthony Taylor Journal: Can J Gastroenterol Date: 2004-10 Impact factor: 3.522
Authors: C van Rensburg; A N Barkun; I Racz; R Fedorak; P C Bornman; C Beglinger; J Balanzó; J Devière; L Kupcinskas; R Luehmann; H Doerfler; S Schäfer-Preuss Journal: Aliment Pharmacol Ther Date: 2008-11-27 Impact factor: 8.171
Authors: Alan Barkun; Sandrine Sabbah; Robert Enns; David Armstrong; Jamie Gregor; Richard N N Fedorak; Elham Rahme; Youssef Toubouti; Myriam Martel; Naoki Chiba; Carlo A Fallone Journal: Am J Gastroenterol Date: 2004-07 Impact factor: 10.864
Authors: James Y Lau; Wai K Leung; Justin C Y Wu; Francis K L Chan; Vincent W S Wong; Philip W Y Chiu; Vivian W Y Lee; Kenneth K C Lee; Frances K Y Cheung; Priscilla Siu; Enders K W Ng; Joseph J Y Sung Journal: N Engl J Med Date: 2007-04-19 Impact factor: 91.245
Authors: Jeffrey L Anderson; Cynthia D Adams; Elliott M Antman; Charles R Bridges; Robert M Califf; Donald E Casey; William E Chavey; Francis M Fesmire; Judith S Hochman; Thomas N Levin; A Michael Lincoff; Eric D Peterson; Pierre Theroux; Nanette Kass Wenger; R Scott Wright; Sidney C Smith; Alice K Jacobs; Cynthia D Adams; Jeffrey L Anderson; Elliott M Antman; Jonathan L Halperin; Sharon A Hunt; Harlan M Krumholz; Frederick G Kushner; Bruce W Lytle; Rick Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel Journal: J Am Coll Cardiol Date: 2007-08-14 Impact factor: 24.094