Rebleeding after Initial Endoscopic Hemostasis in Peptic Ulcer Disease

다국어 초록 (Multilingual Abstract)

Endoscopic hemostasis is the first-line treatment for upper gastrointestinal bleeding (UGIB).
Although several factors are known to be risk factors for rebleeding, little is known aboutthe use of antithrombotics. We tried to verify whether the use of antithrombotics affectsrebleeding rate after a successful endoscopic hemostasis for peptic ulcer disease (PUD).
UGIB patients who underwent successful endoscopic hemostasis were included. Rebleedingwas diagnosed when the previously treated lesion bled again within 30 days of the initialepisode. Of 522 UGIB patients with PUD, rebleeding occurred in 93 patients (17.8%). Therate of rebleeding was higher with aspirin medication (P = 0.006) and after a longendoscopic hemostasis (P < 0.001). Of all significant variables, procedure time longer than13.5 min was related to the rate of rebleeding (OR, 2.899; 95% CI, 1.768-4.754;P < 0.001) on the logistic regression analysis. The rate of rebleeding after endoscopichemostasis for PUD is higher in the patients after a long endoscopic hemostasis.
Endoscopic hemostasis longer than 13.5 min is related to rebleeding after a successfulendoscopic hemostasis for PUD.

참고문헌 (Reference)

1 정일권, "출혈 소화성궤양 치료의 가이드라인" 대한소화기학회 54 (54): 298-308, 2009

2 Lee JK, "Risks related with withholding and resuming anticoagulation in patients with non-variceal upper gastrointestinal bleeding while on warfarin therapy" 66 : 64-68, 2012

3 Restellini S, "Red blood cell transfusion is associated with increased rebleeding in patients with nonvariceal upper gastrointestinal bleeding" 37 : 316-322, 2013

4 Endo M, "Present state of endoscopic hemostasis for nonvariceal upper gastrointestinal bleeding" 22 : S31-S34, 2010

5 Chiu PW, "Predictors of peptic ulcer rebleeding after scheduled second endoscopy: clinical or endoscopic factors?" 38 : 726-729, 2006

6 Maggio D, "Predictors of early rebleeding after endoscopic therapy in patients with nonvariceal upper gastrointestinal bleeding secondary to high-risk lesions" 27 : 454-458, 2013

7 Travis AC, "Model to predict rebleeding following endoscopic therapy for non-variceal upper gastrointestinal hemorrhage" 23 : 1505-1510, 2008

8 Lee SY, "Managing anticoagulation and antiplatelet medications in GI endoscopy: a survey comparing the East and the West" 67 : 1076-1081, 2008

9 Barkun AN, "International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding" 152 : 101-113, 2010

10 Wolf AT, "Impact of anticoagulation on rebleeding following endoscopic therapy for nonvariceal upper gastrointestinal hemorrhage" 102 : 290-296, 2007

11 Sostres C, "Gastrointestinal effects of aspirin" 8 : 385-394, 2011

12 Suehiro T, "Gastrointestinal bleeding associated with antithrombotic therapy in the elderly in Japan" 59 : 774-777, 2012

13 Yamamoto T, "Gastroduodenal mucosal injury in patients on antiplatelet therapy" 120 : 465-469, 2007

14 Tang SJ, "Endoscopic hemostasis in nonvariceal upper gastrointestinal bleeding : comparison of physician practice in the East and the West" 54 : 2418-2426, 2009

15 Kawamura T, "Current status of endoscopic management for nonvariceal upper gastrointestinal bleeding" 22 : S26-S30, 2010

16 Hylek EM, "Complications of oral anticoagulant therapy: bleeding and nonbleeding, rates and risk factors" 3 : 271-278, 2003

17 Chan FK, "Clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding" 352 : 238-244, 2005

18 석기태, "Clinical Outcomes and Risk Factors of Rebleeding Following Endoscopic Therapy for Nonvariceal Upper Gastrointestinal Hemorrhage" 대한소화기내시경학회 44 (44): 93-100, 2011

19 서연석, "Clinical Features and Treatment Outcomes of Upper Gastrointestinal Bleeding in Patients with Cirrhosis" 대한의학회 23 (23): 635-643, 2008