Predictive Factors for Endoscopic Hemostasis in Patients with Upper Gastrointestinal Bleeding

Chung, In Kwon

doi:10.5946/ce.2014.47.2.121

Cited by 5 publications

(3 citation statements)

References 15 publications

(13 reference statements)

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“…In 2014, Giese et al [ 20 ] concluded that in patients with UGIB subject to after-hours endoscopy, a “high-risk” Rockall score permitted an estimation of the risk of death within 30 days, but not of rebleeding. However, Chung [ 21 ] suggested that the pre-endoscopy Rockall score was not useful for predicting the need for therapeutic intervention or adverse outcomes. In 2000, Blatchford et al [ 22 ] identified patients at low or high risk of needing treatment to manage their upper gastrointestinal bleeding with Blatchford score.…”

Section: Discussionmentioning

confidence: 99%

Simple risk factors to predict urgent endoscopy in nonvariceal upper gastrointestinal bleeding pre-endoscopically

Wang

Tang

et al. 2016

Medicine

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The goal of this study is to evaluate how to predict high-risk nonvariceal upper gastrointestinal bleeding (NVUGIB) pre-endoscopically. A total of 569 NVUGIB patients between Match 2011 and January 2015 were retrospectively studied. The clinical characteristics and laboratory data were statistically analyzed. The severity of NVUGIB was based on high-risk NVUGIB (Forrest I–IIb), and low-risk NVUGIB (Forrest IIc and III). By logistic regression and receiver-operating characteristic curve, simple risk score systems were derived which predicted patients’ risks of potentially needing endoscopic intervention to control bleeding. Risk score systems combined of patients’ serum hemoglobin (Hb) ≤75 g/L, red hematemesis, red stool, shock, and blood urine nitrogen ≥8.5 mmol/L within 24 hours after admission were derived. As for each one of these clinical signs, the relatively high specificity was 97.9% for shock, 96.4% for red stool, 85.5% for red hematemesis, 76.7% for Hb ≤75 g/L, and the sensitivity was 50.8% for red hematemesis, 47.5% for Hb ≤75 g/L, 14.2% for red stool, and 10.9% for shock. When these 5 clinical signs were presented as a risk score system, the highest area of receiver-operating characteristic curve was 0.746, with sensitivity 0.675 and specificity 0.733, which discriminated well with high-risk NVUGIB. These simple risk factors identified patients with high-risk NVUGIB of needing treatment to manage their bleeding pre-endoscopically. Further validation in the clinic was required.

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Section: Discussionmentioning

confidence: 99%

Simple risk factors to predict urgent endoscopy in nonvariceal upper gastrointestinal bleeding pre-endoscopically

Wang

Tang

et al. 2016

Medicine

View full text Add to dashboard Cite

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“…In 2014, Giese et al [20] concluded that in patients with UGIB subject to after-hours endoscopy, a "high-risk" Rockall score permitted an estimation of the risk of death within 30 days, but not of rebleeding. However, Chung [21] suggested that the preendoscopy Rockall score was not useful for predicting the need for therapeutic intervention or adverse outcomes. In 2000, Blatchford et al [22] identified patients at low or high risk of needing treatment to manage their upper gastrointestinal bleeding with Blatchford score.…”

Section: Discussionmentioning

confidence: 99%

Simple Risk Factors to Predict Urgent Endoscopy in Nonvariceal Upper Gastrointestinal Bleeding Pre-endoscopically

Wang

Tang

et al. 2017

Clinical Gastroenterology and Hepatology

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“…Peptic ulcer bleeding stands as a frequent cause of hospital admissions, placing a substantial strain on healthcare systems globally. Mortality rates are subject to a multitude of influences, encompassing recent hemorrhage indicators, the proficiency of the performing endoscopist, recurrence of bleeding episodes, the administration of intravenous proton pump inhibitors (PPIs), and the presence of significant comorbidities [ 1 , 2 , 3 , 4 ]. Despite the widespread adoption of endoscopic therapy and acid suppression as primary treatment strategies, the incidence of re-bleeding within 72 h remains notably high, with rates ranging from 4% to 7% following endoscopic intervention [ 5 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Vonoprazan vs. Intravenous Proton Pump Inhibitor in Prevention of Re-Bleeding of High-Risk Peptic Ulcers: A Randomized Controlled Pilot Study

Pattarapuntakul,

Wong,

Wetwittayakhlang

et al. 2024

JCM

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Background: Proton pump inhibitor (PPI) therapy is well-established for its effectiveness in reducing re-bleeding in high-risk peptic ulcer patients following endoscopic hemostasis. Vonoprazan (VPZ) has demonstrated the capacity to achieve gastric pH levels exceeding 4, comparable to PPIs. This study aims to evaluate the comparative efficacy of intravenous PPI infusion versus VPZ in preventing re-bleeding after endoscopic hemostasis in patients with high-risk peptic ulcers. Methods: A randomized, double-blind, controlled, and double-dummy design was employed. Patients with peptic ulcer bleeding (Forrest class IA/IB or IIA/IIB) who underwent endoscopic hemostasis were randomly assigned to either the PPI group or the VPZ group. Re-bleeding rates at 3, 7, and 30 days, the number of blood transfusions required, length of hospitalization, and ulcer healing rate at 56 days were assessed. Results: A total of 44 eligible patients were enrolled, including 20 patients (PPI group, n = 11; VPZ group, n = 9) with high-risk peptic ulcers. The mean age was 66 years, with 70% being male. Re-bleeding within 72 h occurred in 9.1% of the PPI group versus 0% in the VPZ group (p = 1.000). There was no significant difference in re-bleeding rates within 7 days and 30 days (18.2% vs. 11.1%, p = 1.000). Additionally, the ulcer healing rate did not significantly differ between the groups (87.5% vs. 77.8%). Conclusions: This pilot study demonstrates comparable efficacy between oral vonoprazan and continuous PPI infusion in preventing recurrent bleeding events among high-risk peptic ulcer patients following successful endoscopic hemostasis.

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Predictive Factors for Endoscopic Hemostasis in Patients with Upper Gastrointestinal Bleeding

Cited by 5 publications

References 15 publications

Simple risk factors to predict urgent endoscopy in nonvariceal upper gastrointestinal bleeding pre-endoscopically

Simple risk factors to predict urgent endoscopy in nonvariceal upper gastrointestinal bleeding pre-endoscopically

Simple Risk Factors to Predict Urgent Endoscopy in Nonvariceal Upper Gastrointestinal Bleeding Pre-endoscopically

Efficacy of Vonoprazan vs. Intravenous Proton Pump Inhibitor in Prevention of Re-Bleeding of High-Risk Peptic Ulcers: A Randomized Controlled Pilot Study

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