Sung Bum Kim1, Si Hyung Lee2, Kyeong Ok Kim1, Byung Ik Jang1, Tae Nyeun Kim1, Seong Woo Jeon3, Joong Goo Kwon4, Eun Young Kim4, Jin Tae Jung4, Kyung Sik Park5, Kwang Bum Cho5, Eun Soo Kim5, Hyun Jin Kim6, Chang Keun Park7, Jeong Bae Park8, Chang Heon Yang8. 1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, 705-703, Republic of Korea. 2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, 705-703, Republic of Korea. dr9696@nate.com. 3. Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea. 4. Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea. 5. Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea. 6. Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Republic of Korea. 7. Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea. 8. Department of Internal Medicine, Dongguk University School of Medicine, Daegu, Republic of Korea.
Abstract
BACKGROUND: Re-bleeding after initial hemostasis in peptic ulcer bleeding can be life threatening. Identification of factors associated with re-bleeding is important. The aims of this study were to determine incidence of rebleeding in patients with high risk peptic ulcer bleeding and to evaluate factors associated with rebleeding. METHODS: Among patients diagnosed as upper gastrointestinal hemorrhage at seven hospitals in Daegu-Gyeongbuk, and one hospital in Gyeongnam, South Korea, from Feb 2011 to Dec 2013, 699 patients diagnosed as high risk peptic ulcer bleeding with Forrest classification above llb were included. The data were obtained in a prospective manner. RESULTS: Among 699 patients, re-bleeding occurred in 64 (9.2 %) patients. Second look endoscopy was significantly more performed in the non-rebleeding group than the rebleeding group (81.8 vs 62.5 %, p < 0.001). In multivariate analysis, use of non-steroidal anti-inflammatory agents, larger transfusion volume (≥5 units), and non-performance of second look endoscopy were found as risk factors for rebleeding in high risk peptic ulcer bleeding. CONCLUSION: In our study, rebleeding was observed in 9.2 % of patients with high risk peptic ulcer bleeding. Performance of second look endoscopy seems to lower the risk of rebleeding in high risk peptic ulcer bleeding patients and caution should be paid to patients receiving high volume transfusion and on medication with NSAIDs.
BACKGROUND: Re-bleeding after initial hemostasis in peptic ulcer bleeding can be life threatening. Identification of factors associated with re-bleeding is important. The aims of this study were to determine incidence of rebleeding in patients with high risk peptic ulcer bleeding and to evaluate factors associated with rebleeding. METHODS: Among patients diagnosed as upper gastrointestinal hemorrhage at seven hospitals in Daegu-Gyeongbuk, and one hospital in Gyeongnam, South Korea, from Feb 2011 to Dec 2013, 699 patients diagnosed as high risk peptic ulcer bleeding with Forrest classification above llb were included. The data were obtained in a prospective manner. RESULTS: Among 699 patients, re-bleeding occurred in 64 (9.2 %) patients. Second look endoscopy was significantly more performed in the non-rebleeding group than the rebleeding group (81.8 vs 62.5 %, p < 0.001). In multivariate analysis, use of non-steroidal anti-inflammatory agents, larger transfusion volume (≥5 units), and non-performance of second look endoscopy were found as risk factors for rebleeding in high risk peptic ulcer bleeding. CONCLUSION: In our study, rebleeding was observed in 9.2 % of patients with high risk peptic ulcer bleeding. Performance of second look endoscopy seems to lower the risk of rebleeding in high risk peptic ulcer bleedingpatients and caution should be paid to patients receiving high volume transfusion and on medication with NSAIDs.
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