Impact of peptic ulcer bleeding on the in-hospital outcomes of cirrhotic patients with acute gastrointestinal bleeding: an international multicenter study.

IF 3.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Expert Review of Gastroenterology & Hepatology Pub Date : 2024-08-01 Epub Date: 2024-08-12 DOI:10.1080/17474124.2024.2387823

Yuhang Yin, Fanpu Ji, Fernando Gomes Romeiro, Mingyu Sun, Qiang Zhu, Dapeng Ma, Shanshan Yuan, Yingli He, Xiaofeng Liu, Cyriac Abby Philips, Nahum Méndez-Sánchez, Metin Basaranoglu, Kanokwan Pinyopornpanish, Yiling Li, Yunhai Wu, Yu Chen, Ling Yang, Lichun Shao, Andrea Mancuso, Frank Tacke, Su Lin, Bimin Li, Lei Liu, Xingshun Qi

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引用次数: 0

Abstract

Objectives: Peptic ulcer is the most common source of non-variceal bleeding. However, it remains controversial whether the outcomes of cirrhotic patients with peptic ulcer bleeding differ from those with variceal bleeding.

Methods: Cirrhotic patients with acute gastrointestinal bleeding (AGIB) who underwent endoscopy and had an identifiable source of bleeding were retrospectively screened from an international multicenter cohort. Logistic regression analyses were performed to explore the impact of peptic ulcer bleeding on in-hospital death and 5-day failure to control bleeding. Propensity score matching (PSM) analysis was performed by matching age, gender, Child-Pugh score, and model for end-stage liver disease score between the peptic ulcer bleeding and variceal bleeding groups.

Results: Overall, 1535 patients were included, of whom 73 (4.7%) had peptic ulcer bleeding. Multivariate logistic regression analyses showed that peptic ulcer bleeding was not independently associated with in-hospital death (OR = 2.169, p = 0.126) or 5-day failure to control bleeding (OR = 1.230, p = 0.680). PSM analyses demonstrated that both in-hospital mortality (9.7% vs. 6.3%, p = 0.376) and rate of 5-day failure to control bleeding (6.9% vs. 5.4%, p = 0.787) were not significantly different between the two groups.

Conclusions: The impact of peptic ulcer bleeding on the in-hospital outcomes of cirrhotic patients is similar to that of variceal bleeding.

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消化性溃疡出血对急性消化道出血肝硬化患者院内预后的影响：一项国际多中心研究。

目的：消化性溃疡是非静脉曲张出血最常见的原因。然而，消化性溃疡出血的肝硬化患者与静脉曲张出血的肝硬化患者的预后是否不同仍存在争议：方法：从国际多中心队列中回顾性筛选出接受内镜检查并有可确定出血来源的急性消化道出血（AGIB）肝硬化患者。进行了逻辑回归分析，以探讨消化性溃疡出血对院内死亡和 5 天出血控制失败的影响。通过在消化性溃疡出血组和静脉曲张出血组之间匹配年龄、性别、Child-Pugh评分和终末期肝病评分模型，进行倾向评分匹配（PSM）分析：共纳入 1535 例患者，其中 73 例（4.7%）为消化性溃疡出血。多变量逻辑回归分析显示，消化性溃疡出血与院内死亡（OR = 2.169，P = 0.126）或5天出血控制失败（OR = 1.230，P = 0.680）无独立关联。PSM分析表明，两组患者的院内死亡率（9.7% vs. 6.3%，p = 0.376）和5天出血控制失败率（6.9% vs. 5.4%，p = 0.787）均无显著差异：结论：消化性溃疡出血对肝硬化患者院内预后的影响与静脉曲张出血相似：临床试验注册：NCT04662918。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

6.80

自引率

2.60%

发文量

审稿时长

6-12 weeks

期刊介绍： The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.