Jussi M Kärkkäinen1,2, Sami Miilunpohja3,4, Tuomo Rantanen5, Jenni M Koskela6, Johanna Jyrkkä7, Juha Hartikainen3,6, Hannu Paajanen5,6. 1. Heart Center, Kuopio University Hospital, PL 100, 70029, Kuopio, KYS, Finland. jkarkkai@gmail.com. 2. Department of Gastrointestinal Surgery, Kuopio University Hospital, Kuopio, Finland. jkarkkai@gmail.com. 3. Heart Center, Kuopio University Hospital, PL 100, 70029, Kuopio, KYS, Finland. 4. Emergency Department, Kuopio University Hospital, Kuopio, Finland. 5. Department of Gastrointestinal Surgery, Kuopio University Hospital, Kuopio, Finland. 6. School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland. 7. Assessment of Pharmacotherapies, Finnish Medicines Agency, Kuopio, Finland.
Abstract
BACKGROUND: No current data are available on rebleeding and mortality risk in patients who use alcohol excessively and are admitted for non-variceal upper gastrointestinal bleeding (NVUGIB). This information could help in planning interventions and follow-up protocols for these patients. AIM: This study provides contemporary data on the long-term outcome after first-time NVUGIB in alcohol abusers (AAs) compared to non-abusers (NAs). METHODS: Consecutive patients hospitalized for their first acute gastrointestinal bleeding from 2009 through 2011 were retrospectively recorded and categorized as AA or NA. Risk factors for one-year mortality and rebleeding were identified, and patients were further monitored for long-term mortality until 2015. RESULTS: Alcohol abuse was identified in 19.7% of patients with NVUGIB (n = 518). The one-year rebleeding rate was 16.7% in AAs versus 9.1% in NAs (P = 0.027). Alcohol abuse was associated with a twofold increase in rebleeding risk (P = 0.025); the risk especially increased 6 months after the initial bleeding. The study groups did not differ significantly in 30-day (6.0%) or one-year mortality rates (20.5%). However, there was a tendency for higher overall mortality in AAs than NAs after adjustment of comorbidities. CONCLUSION: AAs with NVUGIB are at high risk of rebleeding, and mortality is increased in AA patients. A close follow-up strategy and long-term proton pump inhibitor therapy are recommended for AA patients with peptic ulcer or esophagitis.
BACKGROUND: No current data are available on rebleeding and mortality risk in patients who use alcohol excessively and are admitted for non-variceal upper gastrointestinal bleeding (NVUGIB). This information could help in planning interventions and follow-up protocols for these patients. AIM: This study provides contemporary data on the long-term outcome after first-time NVUGIB in alcohol abusers (AAs) compared to non-abusers (NAs). METHODS: Consecutive patients hospitalized for their first acute gastrointestinal bleeding from 2009 through 2011 were retrospectively recorded and categorized as AA or NA. Risk factors for one-year mortality and rebleeding were identified, and patients were further monitored for long-term mortality until 2015. RESULTS:Alcohol abuse was identified in 19.7% of patients with NVUGIB (n = 518). The one-year rebleeding rate was 16.7% in AAs versus 9.1% in NAs (P = 0.027). Alcohol abuse was associated with a twofold increase in rebleeding risk (P = 0.025); the risk especially increased 6 months after the initial bleeding. The study groups did not differ significantly in 30-day (6.0%) or one-year mortality rates (20.5%). However, there was a tendency for higher overall mortality in AAs than NAs after adjustment of comorbidities. CONCLUSION:AAs with NVUGIB are at high risk of rebleeding, and mortality is increased in AA patients. A close follow-up strategy and long-term proton pump inhibitor therapy are recommended for AA patients with peptic ulcer or esophagitis.
Authors: Tunde Akinyeke; Sydney J Weber; April T Davenport; Erich J Baker; James B Daunais; Jacob Raber Journal: Behav Brain Res Date: 2016-11-08 Impact factor: 3.332
Authors: Lisa L Strate; Prashant Singh; Matthew R Boylan; Sorbarikor Piawah; Yin Cao; Andrew T Chan Journal: PLoS One Date: 2016-11-08 Impact factor: 3.240
Authors: Edilane Rodrigues Dantas De Araújo; Gerlane Coelho Bernardo Guerra; Anderson Wilbur Lopes Andrade; Júlia Morais Fernandes; Valéria Costa Da Silva; Emanuella De Aragão Tavares; Aurigena Antunes De Araújo; Raimundo Fernandes de Araújo Júnior; Silvana Maria Zucolotto Journal: Front Pharmacol Date: 2021-12-16 Impact factor: 5.810