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Article: The Effect of Endoscopic Therapy in Patients Receiving Omeprazole for Bleeding Ulcers with Nonbleeding Visible Vessels or Adherent Clots: A Randomized Comparison

TitleThe Effect of Endoscopic Therapy in Patients Receiving Omeprazole for Bleeding Ulcers with Nonbleeding Visible Vessels or Adherent Clots: A Randomized Comparison
Authors
Issue Date2003
PublisherAmerican College of Physicians. The Journal's web site is located at http://www.annals.org
Citation
Annals Of Internal Medicine, 2003, v. 139 n. 4, p. 237-243+I12 How to Cite?
AbstractBackground: The optimal treatment of ulcers with nonbleeding visible vessels and adherent clots is unclear. Objective: To compare intravenous omeprazole infusion plus endoscopic therapy with intravenous omeprazole infusion alone for prevention of recurrent bleeding from ulcers with nonbleeding visible vessels or adherent clots. Design: Single-blind randomized study with blinded evaluation of study end points. Setting: An endoscopy center in a university hospital in Hong Kong. Patients: 156 persons with upper gastrointestinal bleeding and ulcers showing nonbleeding visible vessels or adherent clots. Intervention: Combination of endoscopic therapy and omeprazole infusion versus sham endoscopic therapy and omeprazole infusion. Measurements: Recurrent ulcer bleeding before discharge and within 30 days. Results: 78 patients were recruited in each group. Ulcer bleeding recurred before discharge in seven patients who received intravenous omeprazole alone (9%) and no patients who received combined therapy (difference, 9 percentage points [95% CI, 1.7 to 17.6 percentage points]; P = 0.01). The probability of recurrent bleeding within 30 days was 11.6% (9 patients) in the omeprazole-alone group and 1.1% (1 patient) in the combined therapy group (difference, 10.5 percentage points [CI, 1.7 to 19.8 percentage points]; P = 0.009). Patients in the combined therapy group required less transfusion (difference in median units of blood transfused, 1 unit [CI, 0 to 2 units]; P = 0.02). One patient in the combined therapy group had surgery for ulcer perforation. Four patients receiving omeprazole alone (5.1%) and two patients receiving combined therapy (2.6%) died within 30 days. Conclusion: The combination of endoscopic therapy and omeprazole infusion is superior to omeprazole infusion alone for preventing recurrent bleeding from ulcers with nonbleeding visible vessels and adherent clots.
Persistent Identifierhttp://hdl.handle.net/10722/162718
ISSN
2023 Impact Factor: 19.6
2023 SCImago Journal Rankings: 3.337
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSung, JJYen_US
dc.contributor.authorChan, FKLen_US
dc.contributor.authorLau, JYWen_US
dc.contributor.authorYung, MYen_US
dc.contributor.authorLeung, WKen_US
dc.contributor.authorWu, JCYen_US
dc.contributor.authorNg, EKWen_US
dc.contributor.authorChung, SCSen_US
dc.date.accessioned2012-09-05T05:22:46Z-
dc.date.available2012-09-05T05:22:46Z-
dc.date.issued2003en_US
dc.identifier.citationAnnals Of Internal Medicine, 2003, v. 139 n. 4, p. 237-243+I12en_US
dc.identifier.issn0003-4819en_US
dc.identifier.urihttp://hdl.handle.net/10722/162718-
dc.description.abstractBackground: The optimal treatment of ulcers with nonbleeding visible vessels and adherent clots is unclear. Objective: To compare intravenous omeprazole infusion plus endoscopic therapy with intravenous omeprazole infusion alone for prevention of recurrent bleeding from ulcers with nonbleeding visible vessels or adherent clots. Design: Single-blind randomized study with blinded evaluation of study end points. Setting: An endoscopy center in a university hospital in Hong Kong. Patients: 156 persons with upper gastrointestinal bleeding and ulcers showing nonbleeding visible vessels or adherent clots. Intervention: Combination of endoscopic therapy and omeprazole infusion versus sham endoscopic therapy and omeprazole infusion. Measurements: Recurrent ulcer bleeding before discharge and within 30 days. Results: 78 patients were recruited in each group. Ulcer bleeding recurred before discharge in seven patients who received intravenous omeprazole alone (9%) and no patients who received combined therapy (difference, 9 percentage points [95% CI, 1.7 to 17.6 percentage points]; P = 0.01). The probability of recurrent bleeding within 30 days was 11.6% (9 patients) in the omeprazole-alone group and 1.1% (1 patient) in the combined therapy group (difference, 10.5 percentage points [CI, 1.7 to 19.8 percentage points]; P = 0.009). Patients in the combined therapy group required less transfusion (difference in median units of blood transfused, 1 unit [CI, 0 to 2 units]; P = 0.02). One patient in the combined therapy group had surgery for ulcer perforation. Four patients receiving omeprazole alone (5.1%) and two patients receiving combined therapy (2.6%) died within 30 days. Conclusion: The combination of endoscopic therapy and omeprazole infusion is superior to omeprazole infusion alone for preventing recurrent bleeding from ulcers with nonbleeding visible vessels and adherent clots.en_US
dc.languageengen_US
dc.publisherAmerican College of Physicians. The Journal's web site is located at http://www.annals.orgen_US
dc.relation.ispartofAnnals of Internal Medicineen_US
dc.subject.meshAnti-Ulcer Agents - Therapeutic Useen_US
dc.subject.meshCombined Modality Therapyen_US
dc.subject.meshEndoscopy, Gastrointestinalen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshGastrointestinal Hemorrhage - Pathology - Prevention & Control - Therapyen_US
dc.subject.meshHemostatic Techniquesen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOmeprazole - Therapeutic Useen_US
dc.subject.meshProton Pumps - Antagonists & Inhibitorsen_US
dc.subject.meshRecurrenceen_US
dc.subject.meshSingle-Blind Methoden_US
dc.subject.meshStomach Ulcer - Prevention & Control - Therapyen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleThe Effect of Endoscopic Therapy in Patients Receiving Omeprazole for Bleeding Ulcers with Nonbleeding Visible Vessels or Adherent Clots: A Randomized Comparisonen_US
dc.typeArticleen_US
dc.identifier.emailLeung, WK:waikleung@hku.hken_US
dc.identifier.authorityLeung, WK=rp01479en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.7326/0003-4819-139-4-200308190-00005-
dc.identifier.pmid12965978-
dc.identifier.scopuseid_2-s2.0-0141454746en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0141454746&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume139en_US
dc.identifier.issue4en_US
dc.identifier.spage237en_US
dc.identifier.epage243+I12en_US
dc.identifier.isiWOS:000184795600001-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridSung, JJY=35405352400en_US
dc.identifier.scopusauthoridChan, FKL=7202586434en_US
dc.identifier.scopusauthoridLau, JYW=13907867100en_US
dc.identifier.scopusauthoridYung, MY=7101896866en_US
dc.identifier.scopusauthoridLeung, WK=7201504523en_US
dc.identifier.scopusauthoridWu, JCY=7409253910en_US
dc.identifier.scopusauthoridNg, EKW=7201647539en_US
dc.identifier.scopusauthoridChung, SCS=19642462800en_US
dc.identifier.issnl0003-4819-

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