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Intravenous Albumin Shortens the Duration of Hospitalization for Patients with Hypoalbuminemia and Bleeding Peptic Ulcers: A Pilot Study

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Abstract

Background

Patients with hypoalbuminemia have an increased risk of ulcer rebleeding and longer length of hospitalization.

Aims

This study aimed to test whether intravenous albumin can decrease the incidence of rebleeding or shorten the duration of hospitalization in patients with bleeding peptic ulcers and hypoalbuminemia.

Methods

Sixty-two patients with bleeding peptic ulcers and Rockall scores ≥6 were prospectively enrolled after having received endoscopic therapy. The enrolled patients were divided into a normal albumin group (serum albumin ≥3 g/dL, n = 39) or an intervention group (<3 g/dL, n = 23) to receive a 3-day course of omeprazole infusion and 25-day oral esomeprazole. Patients (n = 29) with bleeding ulcers and hypoalbuminemia who received the same dose of intravenous and oral omeprazole but did not receive albumin therapy were enrolled from a previous study as the control group. In the intervention group, patients received albumin infusion (10 g q8h) for 1 day (serum albumin levels 2.5–2.9 g/dL) and 2 days (<2.5 g/dL), respectively.

Results

The 28-day cumulative rebleeding rates were similar between the intervention group and the control group (39.1 vs. 42.3 %, p = 0.99). The intervention group had a shorter duration of hospitalization (9 vs. 15 days, p = 0.02) than cohort controls. The risk of rebleeding developed after discharge were similar (normal albumin group vs. intervention group vs. control group, 1/5 [20 %] vs. 2/9 [22.2 %] vs. 1/11 [9.1 %], p = 0.7).

Conclusions

Albumin administration shortens the duration of hospitalization for patients with peptic ulcer bleeding and hypoalbuminemia, but does not decrease the incidence of rebleeding.

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Abbreviations

SRH:

Stigmata of recent hemorrhage

IQR:

Interquartile range

GU:

Gastric ulcer

DU:

Duodenal ulcer

EU:

Esophageal ulcer

H. pylori :

Helicobacter pylori

NSAID:

Non-steroidal anti-inflammatory drugs

ASA:

American Society of Anesthesiologists

PT:

Pro-thrombin time

APTT:

Activated partial thromboplastin time

ITT:

Intention-to-treat

PP:

Per-protocol

U:

Unit

Hb:

Hemoglobin

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Acknowledgments

This study was funded in part by research grants from the National Science Council of Taiwan (NSC 97-2314-B-006-038-MY3) and the National Cheng Kung University Hospital in Tainan, Taiwan (NCKUH-9904006).

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Medical College, National Cheng Kung University, 138 Sheng Li Road, Tainan, Taiwan

    Hsiu-Chi Cheng, Wei-Lun Chang, Wei-Ying Chen & Bor-Shyang Sheu

  2. Institute of Clinical Medicine, Medical College, National Cheng Kung University, 138 Sheng Li Road, Tainan, Taiwan

    Yu-Ching Tsai

  3. Institute of Basic Medical Sciences, Medical College, National Cheng Kung University, 138 Sheng Li Road, Tainan, Taiwan

    Yi-Chun Yeh

  4. Department of Internal Medicine, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan, Taiwan

    Bor-Shyang Sheu

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  1. Hsiu-Chi Cheng
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Correspondence to Bor-Shyang Sheu.

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Cheng, HC., Chang, WL., Chen, WY. et al. Intravenous Albumin Shortens the Duration of Hospitalization for Patients with Hypoalbuminemia and Bleeding Peptic Ulcers: A Pilot Study. Dig Dis Sci 58, 3232–3241 (2013). https://doi.org/10.1007/s10620-013-2821-8

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  • DOI: https://doi.org/10.1007/s10620-013-2821-8

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