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Digestive Diseases and Sciences

, Volume 61, Issue 2, pp 517–522 | Cite as

Risk Factors Associated with Rebleeding in Patients with High Risk Peptic Ulcer Bleeding: Focusing on the Role of Second Look Endoscopy

  • Sung Bum Kim
  • Si Hyung Lee
  • Kyeong Ok Kim
  • Byung Ik Jang
  • Tae Nyeun Kim
  • Seong Woo Jeon
  • Joong Goo Kwon
  • Eun Young Kim
  • Jin Tae Jung
  • Kyung Sik Park
  • Kwang Bum Cho
  • Eun Soo Kim
  • Hyun Jin Kim
  • Chang Keun Park
  • Jeong Bae Park
  • Chang Heon Yang
Original Article

Abstract

Background

Re-bleeding after initial hemostasis in peptic ulcer bleeding can be life threatening. Identification of factors associated with re-bleeding is important. The aims of this study were to determine incidence of rebleeding in patients with high risk peptic ulcer bleeding and to evaluate factors associated with rebleeding.

Methods

Among patients diagnosed as upper gastrointestinal hemorrhage at seven hospitals in Daegu–Gyeongbuk, and one hospital in Gyeongnam, South Korea, from Feb 2011 to Dec 2013, 699 patients diagnosed as high risk peptic ulcer bleeding with Forrest classification above llb were included. The data were obtained in a prospective manner.

Results

Among 699 patients, re-bleeding occurred in 64 (9.2 %) patients. Second look endoscopy was significantly more performed in the non-rebleeding group than the rebleeding group (81.8 vs 62.5 %, p < 0.001). In multivariate analysis, use of non-steroidal anti-inflammatory agents, larger transfusion volume (≥5 units), and non-performance of second look endoscopy were found as risk factors for rebleeding in high risk peptic ulcer bleeding.

Conclusion

In our study, rebleeding was observed in 9.2 % of patients with high risk peptic ulcer bleeding. Performance of second look endoscopy seems to lower the risk of rebleeding in high risk peptic ulcer bleeding patients and caution should be paid to patients receiving high volume transfusion and on medication with NSAIDs.

Keywords

Rebleeding Stomach ulcer Duodenal ulcer Second look endoscopy Blood transfusion 

Notes

Compliance with ethical standards

Conflicts of interest

No potential conflict of interest relevant to this article was reported.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Sung Bum Kim
    • 1
  • Si Hyung Lee
    • 1
  • Kyeong Ok Kim
    • 1
  • Byung Ik Jang
    • 1
  • Tae Nyeun Kim
    • 1
  • Seong Woo Jeon
    • 2
  • Joong Goo Kwon
    • 3
  • Eun Young Kim
    • 3
  • Jin Tae Jung
    • 3
  • Kyung Sik Park
    • 4
  • Kwang Bum Cho
    • 4
  • Eun Soo Kim
    • 4
  • Hyun Jin Kim
    • 5
  • Chang Keun Park
    • 6
  • Jeong Bae Park
    • 7
  • Chang Heon Yang
    • 7
  1. 1.Division of Gastroenterology and Hepatology, Department of Internal MedicineYeungnam University College of MedicineNam-guRepublic of Korea
  2. 2.Department of Internal MedicineKyungpook National University School of MedicineDaeguRepublic of Korea
  3. 3.Department of Internal MedicineCatholic University of Daegu School of MedicineDaeguRepublic of Korea
  4. 4.Department of Internal MedicineKeimyung University School of MedicineDaeguRepublic of Korea
  5. 5.Department of Internal MedicineGyeongsang National University School of MedicineJinjuRepublic of Korea
  6. 6.Department of Internal MedicineDaegu Fatima HospitalDaeguRepublic of Korea
  7. 7.Department of Internal MedicineDongguk University School of MedicineDaeguRepublic of Korea

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