Intravenous non-high-dose pantoprazole is equally effective as high-dose pantoprazole in preventing rebleeding among low risk patients with a bleeding peptic ulcer after initial endoscopic hemostasis
| Autor: | Chih-Ming Liang, Keng-Liang Wu, Wei-Chen Tai, King-Wah Chiu, Seng-Kee Chuah, Ming-Luen Hu, Yi-Chun Chiu, Tsung-Hui Hu, Jyong-Hong Lee, Yeh-Pin Chou, Yuan-Hung Kuo |
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| Jazyk: | angličtina |
| Předmět: |
Peptic ulcer bleeding
Male medicine.medical_specialty Peptic Ulcer Hemorrhage Gastroenterology 2-Pyridinylmethylsulfinylbenzimidazoles Hemoglobins Internal medicine medicine Secondary Prevention Humans lcsh:RC799-869 Infusions Intravenous Rockall scores Pantoprazole Aged Retrospective Studies Chi-Square Distribution business.industry Hemostasis Endoscopic Case-control study Retrospective cohort study Rebleeding Proton Pump Inhibitors General Medicine Hepatology Intravenous proton-pump inhibitors Middle Aged Endoscopic hemostasis Hemostasis Case-Control Studies Creatinine Injections Intravenous Multivariate Analysis lcsh:Diseases of the digestive system. Gastroenterology Female business Rockall score Chi-squared distribution medicine.drug Research Article |
| Zdroj: | BMC Gastroenterology BMC Gastroenterology, Vol 12, Iss 1, p 28 (2012) |
| ISSN: | 1471-230X |
| DOI: | 10.1186/1471-230x-12-28 |
| Popis: | Background Many studies have shown that high-dose proton-pumps inhibitors (PPI) do not further reduce the rate of rebleeding compared to non-high-dose PPIs but we do not know whether intravenous non-high-dose PPIs reduce rebleeding rates among patients at low risk (Rockall score < 6) or among those at high risk, both compared to high-dose PPIs. This retrospective case-controlled study aimed to identify the subgroups of these patients that might benefit from treatment with non-high-dose PPIs. Methods Subjects who received high dose and non-high-dose pantoprazole for confirmed acute PU bleeding at a tertiary referral hospital were enrolled (n = 413). They were divided into sustained hemostasis (n = 324) and rebleeding groups (n = 89). The greedy method was applied to allow treatment-control random matching (1:1). Patients were randomly selected from the non-high-dose and high-dose PPI groups who had a high risk peptic ulcer bleeding (n = 104 in each group), and these were then subdivided to two subgroups (Rockall score ≥ 6 vs. < 6, n = 77 vs. 27). Results An initial low hemoglobin level, serum creatinine level, and Rockall score were independent factors associated with rebleeding. After case-control matching, the significant variables between the non-high-dose and high-dose PPI groups for a Rockall score ≥ 6 were the rebleeding rate, and the amount of blood transfused. Case-controlled matching for the subgroup with a Rockall score < 6 showed that the rebleeding rate was similar for both groups (11.1% in each group). Conclusion Intravenous non-high-dose pantoprazole is equally effective as high-dose pantoprazole when treating low risk patients with a Rockall sore were < 6 who have bleeding ulcers and high-risk stigmata after endoscopic hemostasis. |
| Databáze: | OpenAIRE |
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