We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The effect of endoscopic therapy in patients receiving omeprazole for bleeding ulcers with nonbleeding visible vessels or adherent clots: a randomized comparison.
- Authors
Sung JJY; Chan FKL; Lau JYW; Yung M; Leung W; Wu JCY; Ng EKW; Chung SCS; Sung, Joseph J Y; Chan, Francis K L; Lau, James Y W; Yung, Man-Yee; Leung, Wai-Keung; Wu, Justin C Y; Ng, Enders K W; Chung, S C Sydney
- Abstract
<bold>Background: </bold>The optimal treatment of ulcers with nonbleeding visible vessels and adherent clots is unclear.<bold>Objective: </bold>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.<bold>Design: </bold>Single-blind randomized study with blinded evaluation of study end points.<bold>Setting: </bold>An endoscopy center in a university hospital in Hong Kong.<bold>Patients: </bold>156 persons with upper gastrointestinal bleeding and ulcers showing nonbleeding visible vessels or adherent clots.<bold>Intervention: </bold>Combination of endoscopic therapy and omeprazole infusion versus sham endoscopic therapy and omeprazole infusion.<bold>Measurements: </bold>Recurrent ulcer bleeding before discharge and within 30 days.<bold>Results: </bold>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.<bold>Conclusion: </bold>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.
- Publication
Annals of Internal Medicine, 2003, Vol 139, Issue 4, p237
- ISSN
0003-4819
- Publication type
journal article