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• W2126337543 abstract "Background: Rebleeding is a major prognostic factor for mortality in patients with non-variceal upper gastrointestinal hemorrhage (UGIH). Endoscopic therapy is effective, but up to 20% of patients will rebleed. Although there are several predictive models for patients who present with UGIH, little has been done to elucidate the predictors of rebleeding following successful endoscopic therapy. Aim: To determine the factors associated with rebleeding following endoscopic therapy for non-variceal UGIH. Methods: Patients who underwent endoscopic therapy for non-variceal UGIH at an urban academic medical center were identified from an endoscopic database. The outcome of interest was rebleeding within 30 days of a successful initial therapeutic endoscopy. Rebleeding was defined as: 1) fresh hematemesis 2) fresh melena or hematochezia with other evidence of rebleeding (a systolic blood pressure <100 mm Hg, a pulse rate >100 bpm, or a >2 g/dl drop in hemoglobin level within 24 hours), 3) a drop in hemoglobin level >4 g/dl within 24 hours, 4) blood transfusion requirement of > 4 units of blood within 24 hours, or 5) bleeding on endoscopy, bleeding scan or angiography. Data on patient demographics, clinical presentation, past medical history, medication use, endoscopic findings, and treatment outcomes were collected. Univariable analyses were carried out using t-tests, Chi squared tests, and logistic regression. To determine independent predictors of rebleeding, variables that were significant on univariate analysis at a level of 0.05 or that were thought a priori to be important predictors of rebleeding were entered into a multivariable logistic regression model. Results: 152 patients who underwent successful endoscopic therapy for UGIH were identified. The mean age was 65 years and 64% were male. The sources of bleeding were ulcers (62.5%), angioectasias (14.6%), Mallory-Weiss tears (5.6%), Dieulafoy lesions (3.5%), and other causes (13.2%). Rebleeding occurred in 34 patients (22.3%). When adjusted for age, INR, active bleeding at endoscopy and hypotension, the Charlson co-morbidity index (OR 1.21, 95% CI 1.01-1.45, p = 0.036) and post-procedure IV heparin use (OR 7.59, 95% CI 1.15-50.07, p = 0.035) were independent predictors of rebleeding. Conclusions: The Charlson co-morbidity index and the post-procedure use of intravenous heparin are significant clinical predictors of rebleeding following endoscopic therapy for non-variceal upper gastrointestinal hemorrhage." @default.
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• W2126337543 date "2006-04-01" @default.
• W2126337543 modified "2023-10-18" @default.
• W2126337543 title "Predictors of Rebleeding Following Endoscopic Therapy for Non-Variceal Upper Gastrointestinal Hemorrhage" @default.
• W2126337543 doi "https://doi.org/10.1016/j.gie.2006.03.357" @default.
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