Treatment and outcome of gastrointestinal bleeding due to peptic ulcers and erosions – (BLUE study)

Romstad, Katrine Kauczynska; Detlie, Trond Espen; Søberg, Taran; Thomas, Owen; Ricanek, Petr; Jahnsen, Marte Eide; Lerang, Frode; Jahnsen, Jørgen

doi:10.1080/00365521.2021.1988701

Cited by 10 publications

(5 citation statements)

References 30 publications

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“…PUB is an emergency condition with different prognoses in patients depending on whether endoscopic intervention is performed. [7,8] However, adequate endoscopic examination requires a sufficient fasting time. Moreover, when active bleeding continues, it is often difficult to evaluate the cause because of large clots in the gastric cavity.…”

Section: Discussionmentioning

confidence: 99%

Comparison and validation of the Japanese score and other scoring systems in patients with peptic ulcer bleeding: A retrospective study

Kim,

Moon,

Choi

et al. 2023

Medicine

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Acute upper gastrointestinal bleeding (UGIB) is one of the most urgent medical conditions, with peptic ulcer bleeding (PUB) accounting for most gastrointestinal bleeding cases. The Japanese scoring system was developed to predict the probability of intervention in patients with UGIB, and it is more effective than other scoring systems, according to several studies. This study aimed to verify whether the Japanese scoring system is better than other scoring systems in predicting the probability of intervention when limited to PUB in patients with UGIB. We enrolled patients who presented with symptoms of UGIB and were diagnosed with peptic ulcers using endoscopy. The performances of the scoring systems in predicting patient outcomes were validated and compared using the receiver-operating characteristic curve analysis. Additionally, we used the chi-square test, Fisher exact test, and the t test to analyze the association between the patients characteristics and clinical outcomes. Of the 1228 patients diagnosed with peptic ulcers, 90.6% underwent endoscopy. rebleeding occurred in 12.5% of the patients, and 2.5% of the patients died within 30 days. The Japanese score was the most effective in predicting the need for endoscopic intervention for PUB. Sex, systolic blood pressure, hematemesis, syncope, blood urea nitrogen level, and the American Society of Anesthesiologists score were predictive factors for the probability of endoscopic intervention in patients with PUB. The Japanese score is an effective predictor of the probability of endoscopic intervention in patients with PUB.

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Section: Discussionmentioning

confidence: 99%

Comparison and validation of the Japanese score and other scoring systems in patients with peptic ulcer bleeding: A retrospective study

Kim,

Moon,

Choi

et al. 2023

Medicine

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“…Several studies have previously reported the clinical outcomes of upper GI bleeding with each PU or DL, finding that DL was associated with prolonged hospitalization and poor clinical outcomes 6,8–11 . However, to the best of our knowledge, no studies have substantially demonstrated the comparison of clinical outcomes between PU or DL bleeding.…”

Section: Introductionmentioning

confidence: 99%

“…7 Several studies have previously reported the clinical outcomes of upper GI bleeding with each PU or DL, finding that DL was associated with prolonged hospitalization and poor clinical outcomes. 6,[8][9][10][11] However, to the best of our knowledge, no studies have substantially demonstrated the comparison of clinical outcomes between PU or DL bleeding. In this study, we investigated the clinic-epidemiologic features, efficacy of endoscopic therapy, and long-term prognosis of DLs compared with PUs in a large cohort of patients with upper GI bleeding.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of Dieulafoy's lesion compared with peptic ulcer in upper gastrointestinal bleeding

Noh

Cha

et al. 2023

J of Gastro and Hepatol

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Background and Aim Although Dieulafoy's lesion (DL) is an important cause of nonvariceal upper gastrointestinal (GI) bleeding, few studies have investigated the clinico‐epidemiological outcomes due to its rarity. Here, we investigated clinical features of upper GI bleeding caused by peptic ulcer (PU) or DL and compared endoscopic treatment outcomes. Methods Patients with upper GI bleeding resulting from PU or DL who visited emergency room between January 2013 and December 2017 were eligible. Clinical features and treatment outcomes were retrospectively investigated. Results Overall, 728 patients with upper GI bleeding due to PU (n = 669) and DL (n = 59) were enrolled. The median age was 64 years (interquartile range [IQR], 56–75 years), and 74.3% were male. Endoscopic intervention was performed in 53.7% (n = 359) and 98.3% (n = 58) of the PU and DL groups, respectively (P < 0.0001). Patients were matched by sex, age, body mass index, comorbidity, and past medical history, and 190 PU and 52 DL were finally selected. The rebleeding rates within 7 (7.37% vs 17.31%, P = 0.037) and 30 (7.37% vs 26.92%, P < 0.001) days after initial endoscopy were significantly lower in the PU than in the DL group after propensity score matching. During the median follow‐up period of 52 months (IQR, 34–70 months), there was no difference in overall survival rate (67.9% vs 82.7%, P = 0.518). Conclusions Although DL is a rare cause of upper GI bleeding, it requires endoscopic hemostasis more frequently and has a higher rate of rebleeding than PU even after therapeutic endoscopy. Endoscopists should pay attention and perform active endoscopic hemostasis for DL bleeding.

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“…Kubota et al 8 reported that the unsuccessful factors for endoscopic hemostasis were a shock index of >1.53, duodenal ulcer bleeding, exposed blood vessel diameter (>1.9 mm with contrast-enhanced computed tomography), and Forrest Ia. Romstad et al 9 reported that the rebleeding rate after endoscopic hemostasis for peptic ulcer was 14.8%. The predictive factors for rebleeding included any comorbid disease (odds ratio [OR] 3.19, 95% confidence interval [CI] 1.22-10.21), and duodenal ulcer (OR 2.68, 95% CI 0.73-8.92), which was not statistically significant.…”

mentioning

confidence: 99%

“…reported that the unsuccessful factors for endoscopic hemostasis were a shock index of >1.53, duodenal ulcer bleeding, exposed blood vessel diameter (>1.9 mm with contrast‐enhanced computed tomography), and Forrest Ia. Romstad et al 9 . reported that the rebleeding rate after endoscopic hemostasis for peptic ulcer was 14.8%.…”

mentioning

confidence: 99%

Can we find a precise timing for endoscopic intervention in gastrointestinal bleeding?

Kusano

2022

Digestive Endoscopy

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Treatment and outcome of gastrointestinal bleeding due to peptic ulcers and erosions – (BLUE study)

Cited by 10 publications

References 30 publications

Comparison and validation of the Japanese score and other scoring systems in patients with peptic ulcer bleeding: A retrospective study

Comparison and validation of the Japanese score and other scoring systems in patients with peptic ulcer bleeding: A retrospective study

Clinical outcomes of Dieulafoy's lesion compared with peptic ulcer in upper gastrointestinal bleeding

Can we find a precise timing for endoscopic intervention in gastrointestinal bleeding?

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