Risk factors for rebleeding in patients with peptic ulcer bleeding

Aim. To analyze the results of treatment of patients with ulcerative bleeding, to identify the main risk factors for rebleeding in patients with peptic ulcer bleeding. Methods. A retrospective analysis of the treatment results of 240 patients with acute peptic ulcer bleeding who were hospitalized in the Beloretsk Central District Hospital from 2008 to 2018 was carried out. Patients were divided into two groups: group 1 52 patients with rebleeding, group 2 188 patients in whom rebleeding did not occur. Results. Rebleeding in patients with peptic ulcer was observed in 21.7% of cases. The surgical rate was 22.9% and mortality 6.3%. Based on the obtained data, rebleeding should recognize as a risk factor for death [odds ratio (OR) 68.9; 95% confidence interval (CI) 8.8 to 539.7; p 0.001]. Surgical treatment for rebleeding had unsatisfactory results (postoperative mortality in group 1 26.8%, in group 2 0). Risk factors for rebleeding in peptic ulcer bleeding include localization of the ulcer on the lesser curvature of the stomach (OR=2.37; 95% CI=1.18 to 4.74) and the posterior wall of the duodenum (OR=3.84; 95% CI=1.69 to 8.73), as well as Forrest type IIA ulcer (OR=2.67; 95% CI=1.55 to 6.48). Forrest IIc and III ulcers reduce the risk of rebleeding (OR=0.24; 95% CI=0.10 to 0.56). It was found that a shock index, a decreased level of total protein and red blood cells, and an increasing level of urea have a statistically significant relationship with rebleeding in peptic ulcer bleeding. Conclusion. Rebleeding in patients with peptic ulcer is a serious complication of the disease that significantly increases mortality, and predicting the risk of rebleeding is one of the possible tools that can improve treatment outcomes and reduce mortality.

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PEPTIC ULCER BLEEDING. ANALYSIS OF TREATMENT RESULTS AND CAUSES OF ADVERSE OUTCOME

EMERGENCY MEDICAL CARE ◽

10.24884/2072-6716-2021-22-1-58-62 ◽

2021 ◽

Vol 22 (1) ◽

pp. 58-62

Author(s):

M. V. Valeev ◽

S. V. Timerbulatov

Keyword(s):

Peptic Ulcer ◽

Preventive Measures ◽

Adverse Outcome ◽

Postoperative Mortality ◽

Adverse Outcomes ◽

Ulcer Bleeding ◽

Routine Practice ◽

Peptic Ulcer Bleeding ◽

Treatment Results ◽

Results Of Treatment

The article analyzes the results of treatment of patients with peptic ulcer bleeding in two clinics. One of the main reasons for the adverse outcomes of treatment is rebleeding. Early identification of patients with a high risk of rebleeding will allow timely preventive measures to be taken and avoid the development of severe complications, which ultimately will reduce mortality. The use of endoscopic hemostasis in patients with ulcerative bleeding in routine practice can reduce the number of operations, total and postoperative mortality.

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Intestinal Obstruction due to Bezoar in Elderly Patients: Risk Factors and Treatment Results

Emergency Medicine International ◽

10.1155/2019/3647356 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Fatih Altintoprak ◽

Eyup Gemici ◽

Yasin Alper Yildiz ◽

Mustafa Yener Uzunoglu ◽

Taner Kivilcim

Keyword(s):

Risk Factors ◽

Peptic Ulcer ◽

Surgical Technique ◽

Abdominal Surgery ◽

Elderly Patients ◽

Intestinal Obstruction ◽

History Of ◽

Group 2 ◽

Length Of Hospitalization ◽

Group 1

Purpose. Bezoars are foreign particles from the accumulation of indigestible materials in the gastrointestinal system and a rare cause of mechanical intestinal obstruction. We aimed at investigating differences in risk factors for the development of intestinal obstruction associated with bezoar in elderly patients.Methods. Hospital records of patients who underwent surgery associated with phytobezoar between January 2004 and May 2016 were retrospectively evaluated. Patients were divided into two groups [<65 years (Group 1) and ≥65 years (Group 2)]. Data were examined regarding presence of comorbidity, history of abdominal surgery, operation time, bezoar site, surgical technique, length of hospitalization, morbidity, and mortality.Results. Of 121 patients enrolled, 48 (39.7%) were male and 73 (60.3%) were female (range: 24-86 years). Group 1 consisted of 69 patients aged < 65, while Group 2 consisted of 52 patients aged ≥ 65. Comorbidity was reported in 52 (42.9%) patients (mostly diabetes mellitus, 20.7%), while 60 patients (49.6%) had history of abdominal surgery (mostly peptic ulcer, 27.3%). No statistical differences were found between the two groups in terms of sex, bezoar site, surgical technique preferred, history of abdominal surgical intervention, pre- and postoperative CT examination, morbidity rates, and length of hospitalization. But, ratio of peptic ulcer operations history, presence of total comorbidity, and time of surgery decision was higher in Group 2 patients.Conclusion. In bezoar-related intestinal obstruction, duration and outcome of treatment are not affected by age distribution. Possibility of bezoar should primarily be considered in elderly patients with history of peptic ulcer operation.

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