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Article: Bleeding peptic ulcer: A prospective evaluation of risk factors for rebleeding and mortality

TitleBleeding peptic ulcer: A prospective evaluation of risk factors for rebleeding and mortality
Authors
Issue Date1990
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/
Citation
World Journal Of Surgery, 1990, v. 14 n. 2, p. 262-270 How to Cite?
AbstractClinical, endoscopic, and laboratory data were collected prospectively in 701 patients with bleeding peptic ulcer. The overall rebleeding rate was 16.1% and increased the risk of a fatal outcome by 17 fold (1.2% versus 20.6%, p < 0.001). Rebleeding was documented in more than 75% of the group who did not survive following initial conservative management. Rebleeding was more likely (24.1% versus 14.2%, p < 0.02) when shock was present on admission and the risk of a rebleed was doubled in patients over 60 years of age (22.1% versus 10.9%, p < 0.001). Ulcers greater than 1 cm in size carried twice the risk of rebleeding (23.9% versus 12.4%, p < 0.002). Concomitant medical illness had a significant adverse effect on outcome (p < 0.05). Shock on admission was associated with a doubling of mortality figures (9.5% versus 3.7%, p < 0.01). The identification of endoscopic stigmata of recent hemorrhage (ESRH) tripled the risk of mortality (7.5% versus 2.4%, p < 0.002), ESRH were more frequently encountered when ulcer size was larger than 1 cm (61.4% versus 39.8%, p < 0.001). Respective mortality rates for ulcers less than or equal to 1 cm and greater than 1 cm in size were 1.6% and 12.5% (p < 0.001), corresponding mortality figures for patients over 60 years of age being 4.4% and 16.4% (p < 0.002). The risk of a rebleed tripled (6.7% versus 2.6%, p < 0.02) when ESRH were evident. There was a 6-fold increase in mortality following emergency surgery when compared with conservative management of patients in whom no surgical intervention was necessary (2.6% versus 14.9%, p < 0.001). In summary, age over 60 years, previous medical illness, shock on admission, large ulcer size, and ESRH were each associated with an increased risk of rebleeding and mortality.
Persistent Identifierhttp://hdl.handle.net/10722/156339
ISSN
2015 Impact Factor: 2.523
2015 SCImago Journal Rankings: 1.375
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorBranicki, FJen_HK
dc.contributor.authorColeman, SYen_HK
dc.contributor.authorFok, PJen_HK
dc.contributor.authorPritchett, CJen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLai, ECen_HK
dc.contributor.authorMok, FPen_HK
dc.contributor.authorCheung, WIen_HK
dc.contributor.authorLau, PWen_HK
dc.contributor.authorTuen, HHen_HK
dc.contributor.authorLam k, Sen_HK
dc.contributor.authorHui m, Wen_HK
dc.contributor.authorNg, MMen_HK
dc.contributor.authorLam, DKen_HK
dc.contributor.authorTang, APen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2012-08-08T08:42:03Z-
dc.date.available2012-08-08T08:42:03Z-
dc.date.issued1990en_HK
dc.identifier.citationWorld Journal Of Surgery, 1990, v. 14 n. 2, p. 262-270en_HK
dc.identifier.issn0364-2313en_HK
dc.identifier.urihttp://hdl.handle.net/10722/156339-
dc.description.abstractClinical, endoscopic, and laboratory data were collected prospectively in 701 patients with bleeding peptic ulcer. The overall rebleeding rate was 16.1% and increased the risk of a fatal outcome by 17 fold (1.2% versus 20.6%, p < 0.001). Rebleeding was documented in more than 75% of the group who did not survive following initial conservative management. Rebleeding was more likely (24.1% versus 14.2%, p < 0.02) when shock was present on admission and the risk of a rebleed was doubled in patients over 60 years of age (22.1% versus 10.9%, p < 0.001). Ulcers greater than 1 cm in size carried twice the risk of rebleeding (23.9% versus 12.4%, p < 0.002). Concomitant medical illness had a significant adverse effect on outcome (p < 0.05). Shock on admission was associated with a doubling of mortality figures (9.5% versus 3.7%, p < 0.01). The identification of endoscopic stigmata of recent hemorrhage (ESRH) tripled the risk of mortality (7.5% versus 2.4%, p < 0.002), ESRH were more frequently encountered when ulcer size was larger than 1 cm (61.4% versus 39.8%, p < 0.001). Respective mortality rates for ulcers less than or equal to 1 cm and greater than 1 cm in size were 1.6% and 12.5% (p < 0.001), corresponding mortality figures for patients over 60 years of age being 4.4% and 16.4% (p < 0.002). The risk of a rebleed tripled (6.7% versus 2.6%, p < 0.02) when ESRH were evident. There was a 6-fold increase in mortality following emergency surgery when compared with conservative management of patients in whom no surgical intervention was necessary (2.6% versus 14.9%, p < 0.001). In summary, age over 60 years, previous medical illness, shock on admission, large ulcer size, and ESRH were each associated with an increased risk of rebleeding and mortality.en_HK
dc.languageengen_US
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/en_HK
dc.relation.ispartofWorld Journal of Surgeryen_HK
dc.subject.meshFemaleen_US
dc.subject.meshHong Kong - Epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshLogistic Modelsen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPeptic Ulcer Hemorrhage - Mortalityen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshRecurrenceen_US
dc.subject.meshRisk Factorsen_US
dc.titleBleeding peptic ulcer: A prospective evaluation of risk factors for rebleeding and mortalityen_HK
dc.typeArticleen_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1007/BF01664889en_HK
dc.identifier.pmid2327100-
dc.identifier.scopuseid_2-s2.0-0025369474en_HK
dc.identifier.volume14en_HK
dc.identifier.issue2en_HK
dc.identifier.spage262en_HK
dc.identifier.epage270en_HK
dc.identifier.isiWOS:A1990CW82000018-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridBranicki, FJ=7003617514en_HK
dc.identifier.scopusauthoridColeman, SY=25960711100en_HK
dc.identifier.scopusauthoridFok, PJ=6601913500en_HK
dc.identifier.scopusauthoridPritchett, CJ=6603960556en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLai, EC=36932159600en_HK
dc.identifier.scopusauthoridMok, FP=6603786245en_HK
dc.identifier.scopusauthoridCheung, WI=36934688700en_HK
dc.identifier.scopusauthoridLau, PW=7102543485en_HK
dc.identifier.scopusauthoridTuen, HH=6602991320en_HK
dc.identifier.scopusauthoridLam k, S=7402279473en_HK
dc.identifier.scopusauthoridHui m, W=7103196477en_HK
dc.identifier.scopusauthoridNg, MM=7202076310en_HK
dc.identifier.scopusauthoridLam, DK=7201749373en_HK
dc.identifier.scopusauthoridTang, AP=7201845800en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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