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Gut Liver. 2018 May 15;12(3):271-277. doi: 10.5009/gnl17138.

Factors Associated with Rebleeding in Patients with Peptic Ulcer Bleeding: Analysis of the Korean Peptic Ulcer Bleeding (K-PUB) Study.

Author information

1
Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
2
Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
3
Deparment of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
4
Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
5
Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
6
Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
7
Department of Internal Medicine, Yeungnam University School of Medicine, Daegu, Korea.
8
Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
9
Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
10
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
11
Division of Gastroenterology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.
12
Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
13
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
14
Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
15
Department of Internal Medicine, St. Paul Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
16
Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea.
17
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
18
Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea.
19
Division of Gastroenterology, Department of Internal Medicine, Daegu Catholic University College of Medicine, Daegu, Korea.
20
Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
21
Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
22
Department of Internal Medicine, Eulji University College of Medicine, Daejeon, Korea.
23
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
24
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
25
Department of Internal Medicine, Sahmyook Medical Center, Seoul, Korea.
26
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
27
Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
28
Department of Internal Medicine, National Medical Center, Seoul, Korea.

Abstract

Background/Aims:

Rebleeding is associated with mortality in patients with peptic ulcer bleeding (PUB), and risk stratification is important for the management of these patients. The purpose of our study was to examine the risk factors associated with rebleeding in patients with PUB.

Methods:

The Korean Peptic Ulcer Bleeding registry is a large prospectively collected database of patients with PUB who were hospitalized between 2014 and 2015 at 28 medical centers in Korea. We examined the basic characteristics and clinical outcomes of patients in this registry. Univariate and multivariate analyses were performed to identify the factors associated with rebleeding.

Results:

In total, 904 patients with PUB were registered, and 897 patients were analyzed. Rebleeding occurred in 7.1% of the patients (64), and the 30-day mortality was 1.0% (nine patients). According to the multivariate analysis, the risk factors for rebleeding were the presence of co-morbidities, use of multiple drugs, albumin levels, and hematemesis/hematochezia as initial presentations.

Conclusions:

The presence of co-morbidities, use of multiple drugs, albumin levels, and initial presentations with hematemesis/hematochezia can be indicators of rebleeding in patients with PUB. The wide use of proton pump inhibitors and prompt endoscopic interventions may explain the low incidence of rebleeding and low mortality rates in Korea.

KEYWORDS:

Peptic ulcer hemorrhage; Rebleeding; Risk factors

PMID:
29409302
PMCID:
PMC5945258
DOI:
10.5009/gnl17138
[Indexed for MEDLINE]
Free PMC Article

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