BACKGROUND: In an era of increasingly shortened admissions, data regarding predictors of early rebleeding among patients with nonvariceal upper gastrointestinal bleeding (NVUGIB) exhibiting high-risk stigmata (HRS) having undergone endoscopic hemostasis are lacking. OBJECTIVES: To determine predictors of early rebleeding, defined as rebleeding before completion of recommended 72 h intravenous proton pump inhibitor infusion postendoscopic hemostasis. METHODS: Data from a national registry of patients with upper gastrointestinal bleeding (the REASON registry) were accessed. Univariable and multivariable analyses were sequentially performed to identify significant independent predictors among a comprehensive list of clinical and laboratory characteristics. RESULTS: Overall, 393 patients underwent endoscopic hemostasis for NVUGIB with HRS. Forty patients rebled ≤72 h thereafter (32.5% female, mean [± SD] age 70.2 ± 11.8 years, 2.88 ± 2.11 comorbidities), while 21 rebled later (38.1% female, mean 70.5 ± 14.1 years of age, 2.62 ± 2.06 comorbidities). Hematemesis or bright red blood per nasogastric tube aspirate was identified as the sole independent significant predictor of early rebleeding versus later among both NVUGIB and, more specifically, patients with peptic ulcer bleeding (OR 7.94 [95% CI 1.80 to 35.01]; P<0.01, and OR 8.41 [95% CI 1.54 to 46.10]; P=0.014, respectively). CONCLUSIONS: When attempting to determine the optimal duration of pharmacotherapy and timing of discharge for patients following endoscopic hemostasis for NVUGIB with HRS, it is noteworthy that individuals who present with hematemesis or bright red blood per nasogastric tube aspirate are at particularly high risk for rebleeding within the first 72 h.
BACKGROUND: In an era of increasingly shortened admissions, data regarding predictors of early rebleeding among patients with nonvariceal upper gastrointestinal bleeding (NVUGIB) exhibiting high-risk stigmata (HRS) having undergone endoscopic hemostasis are lacking. OBJECTIVES: To determine predictors of early rebleeding, defined as rebleeding before completion of recommended 72 h intravenous proton pump inhibitor infusion postendoscopic hemostasis. METHODS: Data from a national registry of patients with upper gastrointestinal bleeding (the REASON registry) were accessed. Univariable and multivariable analyses were sequentially performed to identify significant independent predictors among a comprehensive list of clinical and laboratory characteristics. RESULTS: Overall, 393 patients underwent endoscopic hemostasis for NVUGIB with HRS. Forty patients rebled ≤72 h thereafter (32.5% female, mean [± SD] age 70.2 ± 11.8 years, 2.88 ± 2.11 comorbidities), while 21 rebled later (38.1% female, mean 70.5 ± 14.1 years of age, 2.62 ± 2.06 comorbidities). Hematemesis or bright red blood per nasogastric tube aspirate was identified as the sole independent significant predictor of early rebleeding versus later among both NVUGIB and, more specifically, patients with peptic ulcer bleeding (OR 7.94 [95% CI 1.80 to 35.01]; P<0.01, and OR 8.41 [95% CI 1.54 to 46.10]; P=0.014, respectively). CONCLUSIONS: When attempting to determine the optimal duration of pharmacotherapy and timing of discharge for patients following endoscopic hemostasis for NVUGIB with HRS, it is noteworthy that individuals who present with hematemesis or bright red blood per nasogastric tube aspirate are at particularly high risk for rebleeding within the first 72 h.
Authors: A Andriulli; V Annese; N Caruso; A Pilotto; L Accadia; A G Niro; M Quitadamo; A Merla; S Fiorella; G Leandro Journal: Am J Gastroenterol Date: 2005-01 Impact factor: 10.864
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: Ian C Glenn; Ibrahim Abd El-Shafy; Nicholas E Bruns; E Pete Muenks; Yara K Duran; Joshua A Hill; Shawn D St Peter; Jose M Prince; Aaron M Lipskar; Todd A Ponsky Journal: Pediatr Surg Int Date: 2018-02-19 Impact factor: 1.827
Authors: Mi Jin Hong; Sun-Young Lee; Jeong Hwan Kim; In-Kyung Sung; Hyung Seok Park; Chan Sup Shim; Choon Jo Jin Journal: J Korean Med Sci Date: 2014-10-08 Impact factor: 2.153
Authors: Vrinda Shenoy; Sarina Shah; Sathish Kumar; Deepu David; Karthik Gunasekaran; G Priya; Bagyalakshmi Selvaraj; Kundavaram Paul Prabhakar Abhilash Journal: J Family Med Prim Care Date: 2021-04-08