Comparison between Endoscopic Therapy and Medical Therapy in Peptic Ulcer Patients with Adherent Clot: A Multicenter Prospective Observational Cohort Study / 대한소화기학회지
The Korean Journal of Gastroenterology
;
: 98-105, 2015.
Artigo
em Coreano
| WPRIM
| ID: wpr-118737
ABSTRACT
BACKGROUND/AIMS:
The optimal management of bleeding peptic ulcer with adherent clot remains controversial. The purpose of this study was to compare clinical outcome between endoscopic therapy and medical therapy. We also evaluated the risk factors of rebleeding in Forrest type IIB peptic ulcer.METHODS:
Upper gastrointestinal (UGI) bleeding registry data from 8 hospitals in Korea between February 2011 and December 2013 were reviewed and categorized according to the Forrest classification. Patients with acute UGI bleeding from peptic ulcer with adherent clots were enrolled.RESULTS:
Among a total of 1,101 patients diagnosed with peptic ulcer bleeding, 126 bleedings (11.4%) were classified as Forrest type IIB. Of the 126 patients with adherent clots, 84 (66.7%) received endoscopic therapy and 42 (33.3%) were managed with medical therapy alone. The baseline characteristics of patients in two groups were similar except for higher Glasgow Blatchford Score and pre-endoscopic Rockall score in medical therapy group. Bleeding related mortality (1.2% vs. 10%; p=0.018) and all cause mortality (3.7% vs. 20.0%; p=0.005) were significantly lower in the endoscopic therapy group. However, there was no difference between endoscopic therapy and medical therapy regarding rebleeding (7.1% vs. 9.5%; p=0.641). In multivariate analysis, independent risk factors of rebleeding were previous medication with aspirin and/or NSAID (OR, 13.1; p=0.025).CONCLUSIONS:
In patients with Forrest type IIB peptic ulcer bleeding, endoscopic therapy was associated with a significant reduction in bleeding related mortality and all cause mortality compared with medical therapy alone. Important risk factor of rebleeding was use of aspirin and/or NSAID.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Úlcera Péptica
/
Recidiva
/
Úlcera Péptica Hemorrágica
/
Anti-Inflamatórios não Esteroides
/
Aspirina
/
Análise Multivariada
/
Estudos Prospectivos
/
Fatores de Risco
/
Estudos de Coortes
/
Resultado do Tratamento
Tipo de estudo:
Ensaio Clínico Controlado
/
Estudo de etiologia
/
Estudo de incidência
/
Estudo observacional
/
Fatores de risco
Limite:
Idoso
/
Aged80
/
Feminino
/
Humanos
/
Masculino
Idioma:
Coreano
Revista:
The Korean Journal of Gastroenterology
Ano de publicação:
2015
Tipo de documento:
Artigo
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