Acute Upper Gi Bleeding: Did Anything Change?

Leerdam, Monique E. van; Vreeburg, E. M.; Rauws, E. A. J.; Geraedts, A. A. M.; Tijssen, Jan G.P.; Reitsma, Johannes B.; Tytgat, G. N. J.

doi:10.1111/j.1572-0241.2003.07517.x

Cited by 466 publications

(277 citation statements)

References 31 publications

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“…Despite new improved therapeutic modalities, this unexpected rise in bleeding may be due to other reasons; for example, H. pylori may not be the predominant etiologic factor in patients who experience complications requiring surgery (12,13). During the last decade, PU bleeding did not significantly change (2,5,14), but the incidence increased in patients older than 75 years of age (15). In last decade, usage of non-steroidal anti-inflamatory drugs (NSAID) also increased, especially in the increasing elderly population (16,17).…”

Section: Original Articlementioning

confidence: 99%

Peptic ulcer complications requiring surgery: What has changed in the last 50 years in Turkey

Güzel

Kahramanca²,

Seker³

et al. 2014

Turk J Gastroenterol

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Background/Aims: The incidence and prevalence of peptic ulcer disease has decreased in recent years, but it is not so easy to make the same conclusion when complications of peptic ulcer are taken into consideration. The aim of this study is to determine the time trends in complicated peptic ulcer disease and to state the effects of H2 receptor blockers, proton pump inhibitors (PPI), and H. pylori eradication therapies on these complications. Materials and Methods: This study retrospectively evaluated the patients who were operated on for complications (perforation, bleeding, and obstruction) of peptic ulcer for the last 50 years. Patients were grouped into four groups (G1-G4) according to the dates in which H2 receptor blockers, PPIs, and eradication regimens for H. pylori were introduced The time periods that were studied were: (G1) 1962-1980, (G2) 1981-1990, (G3) 1991-1997, and (G4) 1998-2012. Results: In total, 2953 patients were operated on for complications of peptic ulcer disease, of which 86% of the patients were male. In G1, perforation and obstruction were significantly the most frequent complications (p<0.001), followed by bleeding. In groups G2 and G3, obstruction was still the most frequent complication requiring surgery (p<0.001). In G2 and G3, obstruction was followed by perforation and bleeding, respectively. In G4, perforation was significantly the most frequent complication (p<0.001). Conclusion: From 1962 to 1990 obstruction was the most common complication requiring surgery. In the last decade, perforation became the most common complication. In contrast to reports in the literature, bleeding was the least common complication requiring surgery in Turkey.

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Section: Original Articlementioning

confidence: 99%

Peptic ulcer complications requiring surgery: What has changed in the last 50 years in Turkey

Güzel

Kahramanca²,

Seker³

et al. 2014

Turk J Gastroenterol

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“…The incidence of AUGIB has not decreased among the elderly over the last few decades [2]. Because of the baby-boomer phenomena, the health system will manage more elderly patients presenting with AUGIB.…”

mentioning

confidence: 99%

“…It is estimated that the annual incidence of AUGIB for patients who are 60 years old or older is 545 cases per 100,000 persons [2]. The total number of persons in the USA who were 60 years old or older in the year 2000 was 45,851,200 (16.29%) [3].…”

mentioning

confidence: 99%

An Estimate of Hospitalization Cost for Elderly Patients with Acute Upper Gastrointestinal Bleeding in the USA

2008

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“…Upper gastrointestinal bleeding is an important cause of mortality worldwide (1)(2)(3)(4). Peptic ulcer disease is the most common cause of upper gastrointestinal bleeding (4)(5), and a significant proportion of peptic ulcers are caused by Helicobacter pylori (H. pylori) (6).…”

Section: Introductionmentioning

confidence: 99%

“…Peptic ulcer disease is the most common cause of upper gastrointestinal bleeding (4)(5), and a significant proportion of peptic ulcers are caused by Helicobacter pylori (H. pylori) (6). Guidelines recommend the diagnosis and treatment of H. pylori in upper gastrointestinal bleeding secondary to peptic ulcers (7)(8)(9), but the preferred diagnostic test and the optimal timing of testing (during acute bleeding or after that) is not clear.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and treatment of Helicobacter pylori for peptic ulcer bleeding in clinical practice - factors associated with non-diagnosis and non-treatment, and diagnostic yield in various settings

Lim

Ho²,

So³

et al. 2015

Turk J Gastroenterol

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Background/Aims: To study the practice of clinicians in the diagnosis and treatment of H. pylori for peptic ulcer bleeding, and the diagnostic yield of H. pylori tests in various situations. Materials and Methods: All consecutive patients aged ≥18 years who underwent esophagogastroduodenoscopy for the indications of coffee-grounds vomitus, hematemesis or melena with endoscopically diagnosed peptic ulcers were included. Results: 374 patients were included. H. pylori testing was performed during acute bleeding for 296 patients. 80% of patients who tested negative for H. pylori during the acute episode were planned for repeat H. pylori testing. 11/88 patients who tested negative for H. pylori during the acute episode were positive for H. pylori during repeat testing (diagnostic yield 12.5%). Prior proton-pump inhibitor and antibiotic ingestion within 4 weeks of presentation was associated with lower diagnostic yield for H. pylori. On multivariate analysis, patient's age, systolic blood pressure, heart rate, activated partial thromboplastin time, and need for endoscopic treatment were associated with failure to take biopsies for H. pylori testing during acute episode. 100/106 patients tested positive for H. pylori during the acute episode of gastrointestinal bleeding had H. pylori treatment. Conclusion: Repeat H. pylori testing after index negative H. pylori testing during acute episodes gave a diagnostic yield of 12.5%, reinforcing the importance of repeat testing.

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Acute Upper Gi Bleeding: Did Anything Change?

Cited by 466 publications

References 31 publications

Peptic ulcer complications requiring surgery: What has changed in the last 50 years in Turkey

Peptic ulcer complications requiring surgery: What has changed in the last 50 years in Turkey

An Estimate of Hospitalization Cost for Elderly Patients with Acute Upper Gastrointestinal Bleeding in the USA

Diagnosis and treatment of Helicobacter pylori for peptic ulcer bleeding in clinical practice - factors associated with non-diagnosis and non-treatment, and diagnostic yield in various settings

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