Tags

Type your tag names separated by a space and hit enter

Mortality from nonulcer bleeding is similar to that of ulcer bleeding in high-risk patients with nonvariceal hemorrhage: a prospective database study in Italy.
Gastrointest Endosc. 2012 Feb; 75(2):263-72, 272.e1.GE

Abstract

BACKGROUND

Nonulcer causes of bleeding are often regarded as minor, ie, associated with a lower risk of mortality.

OBJECTIVE

To assess the risk of death from nonulcer causes of upper GI bleeding (UGIB).

DESIGN

Secondary analysis of prospectively collected data from 3 national databases.

SETTINGS

Community and teaching hospitals.

PATIENTS

Consecutive patients admitted for acute nonvariceal UGIB.

INTERVENTIONS

Early endoscopy, medical and endoscopic treatment as appropriate.

MAIN OUTCOME MEASUREMENTS

Thirty-day mortality, recurrent bleeding, and need for surgery.

RESULTS

A total of 3207 patients (65.8% male), mean (standard deviation) age 68.3 (16.4) years, were analyzed. Overall mortality was 4.45% (143 patients). According to the source of bleeding, mortality was 9.8% for neoplasia, 4.8% for Mallory-Weiss tears, 4.8% for vascular lesions, 4.4% for gastroduodenal erosions, 4.4% for duodenal ulcer, and 3.1% for gastric ulcer. Frequency of death was not different among benign endoscopic diagnoses (overall P = .567). Risk of death was significantly higher in patients with neoplasia compared with benign conditions (odds ratio 2.50; 95% CI, 1.32-4.46; P < .0001). Gastric or duodenal ulcer significantly increased the risk of death, but this was not related to the presence of high-risk stigmata (P = .368). The strongest predictor of mortality for all causes of nonvariceal UGIB was the overall physical status of the patient measured with the American Society of Anesthesiologists score (1-2 vs 3-4, P < .001).

LIMITATIONS

No data on the American Society of Anesthesiologists class score in the Prometeo study.

CONCLUSIONS

Nonulcer causes of nonvariceal UGIB have a risk of death, similar to bleeding peptic ulcers in the clinical context of a high-risk patient.

Authors+Show Affiliations

Division of Gastroenterology, Hospital Curto, Polla, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22000792

Citation

Marmo, Riccardo, et al. "Mortality From Nonulcer Bleeding Is Similar to That of Ulcer Bleeding in High-risk Patients With Nonvariceal Hemorrhage: a Prospective Database Study in Italy." Gastrointestinal Endoscopy, vol. 75, no. 2, 2012, pp. 263-72, 272.e1.
Marmo R, Del Piano M, Rotondano G, et al. Mortality from nonulcer bleeding is similar to that of ulcer bleeding in high-risk patients with nonvariceal hemorrhage: a prospective database study in Italy. Gastrointest Endosc. 2012;75(2):263-72, 272.e1.
Marmo, R., Del Piano, M., Rotondano, G., Koch, M., Bianco, M. A., Zambelli, A., Di Matteo, G., Grossi, E., Cipolletta, L., & Prometeo Investigators, . (2012). Mortality from nonulcer bleeding is similar to that of ulcer bleeding in high-risk patients with nonvariceal hemorrhage: a prospective database study in Italy. Gastrointestinal Endoscopy, 75(2), 263-72, e1. https://doi.org/10.1016/j.gie.2011.07.066
Marmo R, et al. Mortality From Nonulcer Bleeding Is Similar to That of Ulcer Bleeding in High-risk Patients With Nonvariceal Hemorrhage: a Prospective Database Study in Italy. Gastrointest Endosc. 2012;75(2):263-72, 272.e1. PubMed PMID: 22000792.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mortality from nonulcer bleeding is similar to that of ulcer bleeding in high-risk patients with nonvariceal hemorrhage: a prospective database study in Italy. AU - Marmo,Riccardo, AU - Del Piano,Mario, AU - Rotondano,Gianluca, AU - Koch,Maurizio, AU - Bianco,Maria Antonia, AU - Zambelli,Alessandro, AU - Di Matteo,Giovanni, AU - Grossi,Enzo, AU - Cipolletta,Livio, AU - ,, AU - ,, AU - Prometeo Investigators,, Y1 - 2011/10/13/ PY - 2011/03/28/received PY - 2011/07/29/accepted PY - 2011/10/18/entrez PY - 2011/10/18/pubmed PY - 2012/5/26/medline SP - 263-72, 272.e1 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 75 IS - 2 N2 - BACKGROUND: Nonulcer causes of bleeding are often regarded as minor, ie, associated with a lower risk of mortality. OBJECTIVE: To assess the risk of death from nonulcer causes of upper GI bleeding (UGIB). DESIGN: Secondary analysis of prospectively collected data from 3 national databases. SETTINGS: Community and teaching hospitals. PATIENTS: Consecutive patients admitted for acute nonvariceal UGIB. INTERVENTIONS: Early endoscopy, medical and endoscopic treatment as appropriate. MAIN OUTCOME MEASUREMENTS: Thirty-day mortality, recurrent bleeding, and need for surgery. RESULTS: A total of 3207 patients (65.8% male), mean (standard deviation) age 68.3 (16.4) years, were analyzed. Overall mortality was 4.45% (143 patients). According to the source of bleeding, mortality was 9.8% for neoplasia, 4.8% for Mallory-Weiss tears, 4.8% for vascular lesions, 4.4% for gastroduodenal erosions, 4.4% for duodenal ulcer, and 3.1% for gastric ulcer. Frequency of death was not different among benign endoscopic diagnoses (overall P = .567). Risk of death was significantly higher in patients with neoplasia compared with benign conditions (odds ratio 2.50; 95% CI, 1.32-4.46; P < .0001). Gastric or duodenal ulcer significantly increased the risk of death, but this was not related to the presence of high-risk stigmata (P = .368). The strongest predictor of mortality for all causes of nonvariceal UGIB was the overall physical status of the patient measured with the American Society of Anesthesiologists score (1-2 vs 3-4, P < .001). LIMITATIONS: No data on the American Society of Anesthesiologists class score in the Prometeo study. CONCLUSIONS: Nonulcer causes of nonvariceal UGIB have a risk of death, similar to bleeding peptic ulcers in the clinical context of a high-risk patient. SN - 1097-6779 UR - https://www.unboundmedicine.com/medline/citation/22000792/Mortality_from_nonulcer_bleeding_is_similar_to_that_of_ulcer_bleeding_in_high_risk_patients_with_nonvariceal_hemorrhage:_a_prospective_database_study_in_Italy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(11)02051-7 DB - PRIME DP - Unbound Medicine ER -