Epidemiology and adherence to guidelines on the management of bleeding peptic ulcer: A prospective multicenter observational study in 1140 patients

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• 作者：Jean-David Zeitoun^a ; ^{jdzeitoun@yahoo.fr} ; Isabelle Rosa-Hé ; zode^b ; Ariane Chryssostalis^c ; Bernard Nalet^d ; Bruno Bour^e ; Jean-Pierre Arpurt^f ; Jacques Denis^g ; Sté ; phane Nahon^h ; Alexandre Parienteⁱ ; Hervé ; Hagè ; ge^b ; the Groupe des Hé ; morragies Digestives Hautes de l&rsquo ; ANGH
• 关键词：UGIB ; upper gastrointestinal bleeding ; ANGH ; Association Nationale des Gastroenté ; rologues des Hô ; pitaux Gé ; né ; raux ; NSAID ; non-steroidal anti-inflammatory drugs ; PPI ; proton pump inhibitor
• 刊名：Clinics and Research in Hepatology and Gastroenterology
• 出版年：2012
• 期刊代码：pca104_22107401
• 类别：med
• 出版时间：June, 2012
• 卷：36
• 期：3
• 页码：227-234
• 文件大小：334 K

摘要

| Figures/TablesFigures/Tables | ReferencesReferences<h3 class="h3">Summaryh3><h4 class="h4">Background and objectiveh4>Mortality of upper gastrointestinal bleeding seems declining. Whether practice guidelines for the management of peptic ulcer bleeding are followed is unknown. We aimed to update epidemiology of peptic ulcer bleeding and to assess the adherence to guidelines in the French community.<h4 class="h4">Methodsh4>

Between March, 2005 and February, 2006, a prospective multicenter study was conducted including all patients with communautary upper gastrointestinal bleeding. Data from patients with peptic ulcer bleeding were extracted and analyzed.<h4 class="h4">Resultsh4>

Out of 3203 analyzable patients included, 1140 (35.6%) had a peptic ulcer bleeding and 965 of them a duodenal and/or gastric ulcer. Seven hundred and thirty-five were male (64.5%) and mean age was 66.4 years (卤18.8). Overall, 699 patients (61.3%) were taking medication inducing upper gastrointestinal bleeding. Two-hundred and sixty-eight (23.5%) patients had endoscopic therapy, 190 (70.9%) of whom had epinephrine injection alone. Among the 349 patients with high risk stigmata on endoscopy (Forrest IA, IB, IIA), 209 (59.9%) underwent endoscopic therapy. One thousand one hundred and seven patients (97.1%) were given proton-pump inhibitors. One hundred and thirty-four patients (11.8%) experienced haemorrhagic recurrence. Forty-eight patients (4.2%) underwent surgery and 61 (5.4%) died.<h4 class="h4">Conclusionsh4>

Consistently with previous studies, mortality of upper gastrointestinal bleeding seems declining. Further progress lies above all in prevention but also probably in better adherence to therapeutic guidelines and management of comorbidities.