AI Article Synopsis
- The study aimed to assess the current epidemiology of peptic ulcer bleeding in France and evaluate how well practice guidelines are being followed among medical professionals.
- Out of 3,203 patients with upper gastrointestinal bleeding, 1,140 had peptic ulcer bleeding, primarily affecting older males, many of whom were on medications that could worsen their condition.
- Results show that while mortality rates from upper GI bleeding are decreasing and the majority of patients received proton-pump inhibitors, there is a need for better adherence to guidelines and management of related health issues to enhance prevention efforts.
Article Abstract
Background And Objective: 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.
Methods: 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.
Results: 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 (±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.
Conclusions: 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.
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| http://dx.doi.org/10.1016/j.clinre.2011.11.008 | DOI Listing |
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