Efficacy of an intravenous proton pump inhibitor after endoscopic therapy with epinephrine injection for peptic ulcer bleeding in patients with uraemia: a case‐control study

Summary Background  Patients with peptic ulcer bleeding and uraemia are prone to re‐bleeding. Aim  To compare the efficacy of an intravenous proton pump inhibitor in treating peptic ulcer bleeding in patients with uraemia and those without uraemia. Methods  High‐risk peptic ulcer bleeding patients r...

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Bibliographic Details
Published in:Alimentary pharmacology & therapeutics 2009-08, Vol.30 (4), p.406-413
Main Authors: TSENG, G.‐Y., FANG, C.‐T., LIN, H.‐J., YANG, H.‐B., TSENG, G.‐C., WANG, P.‐C., LIAO, P.‐C., CHENG, Y.‐T., HUANG, C.‐H.
Format: Article
Language:English
Subjects:
Aged
Anti-Ulcer Agents - administration & dosage
Biological and medical sciences
Blood Transfusion
Case-Control Studies
Digestive system
Drug Administration Schedule
Epinephrine - administration & dosage
Female
Gastroenterology. Liver. Pancreas. Abdomen
Hemostasis, Endoscopic - methods
Humans
Infusions, Intravenous
Injections, Intravenous
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Omeprazole - administration & dosage
Other diseases. Semiology
Peptic Ulcer - therapy
Peptic Ulcer Hemorrhage - prevention & control
Peptic Ulcer Hemorrhage - therapy
Pharmacology. Drug treatments
Proton Pump Inhibitors - administration & dosage
Regression Analysis
Renal failure
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Treatment Outcome
Uremia - complications
Uremia - therapy
Vasoconstrictor Agents - administration & dosage
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Summary:Summary Background  Patients with peptic ulcer bleeding and uraemia are prone to re‐bleeding. Aim  To compare the efficacy of an intravenous proton pump inhibitor in treating peptic ulcer bleeding in patients with uraemia and those without uraemia. Methods  High‐risk peptic ulcer bleeding patients received endoscopic therapy with epinephrine (adrenaline) injection plus intravenous omeprazole (40 mg bolus followed by 40 mg infusion every 12 h) for 3 days. Re‐bleeding, volume of blood transfusion, hospital stay, need for surgery, and mortality were analysed. Results  The uraemic group had similar 7‐day re‐bleeding rate (6/42, 14.29% vs. 6/46, 13.04%, P = 0.865) to that of non‐uraemic patients, but more re‐bleeding episodes beyond 7 days (4/42, 9.52% vs. 0/46, 0%, P = 0.032, OR [95% CI] = 1.105 [1.002–1.219]) and all‐cause mortality (4/42 vs. 0/46 P = 0.032, OR [95% CI] = 1.105 [1.002–1.219]). The uraemic group also had more units of blood transfusion after endoscopic therapy (mean ± s.d. 4.33 ± 3.35 units vs. 2.15 ± 1.65 units, P 
ISSN:0269-2813
1365-2036
DOI:10.1111/j.1365-2036.2009.04049.x