Tags

Type your tag names separated by a space and hit enter

The "Prometeo" study: online collection of clinical data and outcome of Italian patients with acute nonvariceal upper gastrointestinal bleeding.
J Clin Gastroenterol. 2013 Apr; 47(4):e33-7.JC

Abstract

GOALS

To implement an online, prospective collection of clinical data and outcome of patients with acute nonvariceal upper gastrointestinal bleeding (UGIB) in Italy ("Prometeo" study).

BACKGROUND

Epidemiology, clinical features, and outcomes of nonvariceal UGIB are mainly known by retrospective studies and are probably changing.

STUDY

Data were collected by 13 Gastrointestinal Units in Italy from June 2006 to June 2007 (phase 1) and from December 2008 to December 2009 (phase 2): an interim analysis of data was performed between the 2 phases to optimize the online database. All the patients consecutively admitted for acute nonvariceal UGIB were enrolled. Demographic and clinical data were collected, a diagnostic endoscopy performed, with endoscopic hemostasis if indicated.

RESULTS

One thousand four hundred thirteen patients (M=932, mean age±SD=66.5±15.8; F=481, mean age±SD=74.2±14.6) were enrolled. Comorbidities were present in 83%. 52.4% were treated with acetyl salicylic acid or other nonsteroidal anti-inflammatory drugs (NSAIDs): only 13.9% had an effective gastroprotection. Previous episodes of UGIB were present in 13.3%. Transfusion were needed in 43.9%. Shock was present in 9.3%. Endoscopic diagnosis was made in 93.2%: peptic lesions were the main cause of bleeding (duodenal ulcer 36.2%, gastric ulcer 29.6%, gastric/duodenal erosions 10.9%). At endoscopy, Helicobacter pylori was searched in 37.2%, and found positive in 51.3% of tested cases. Early rebleeding was observed in 5.4%: surgery was required in 14.3% of them. Bleeding-related death occurred in 4.0%: at multivariate analysis, the risk of death was correlated with female sex [odds ratio (OR=2.19, P=0.0089)], presence of neoplasia (OR=2.70, P=0.0057) or multiple comorbidities (OR=5.04, P=0.0280), shock at admission (OR=4.55, P=0.0001), and early rebleeding (OR=1.47, P=0.004).

CONCLUSIONS

Prometeo database has provided an up-to-date picture of acute nonvariceal UGIB in Italy: patients are elderly, predominantly males, and with important comorbidities. Gastroprotection is underutilized during NSAIDs treatment. With respect to previous studies, Prometeo shows a higher incidence of low-dose acetyl salicylic acid use and comorbidities, whereas no significant difference were found in other items (etiology of bleeding, NSAIDs use, need for endoscopic hemostasis, incidence of rebleeding, and overall mortality).

Authors+Show Affiliations

Gastroenterology, AOU Maggiore della Carità, Novara, Italy. mario.delpiano@alice.itNo 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
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22914349

Citation

Del Piano, Mario, et al. "The "Prometeo" Study: Online Collection of Clinical Data and Outcome of Italian Patients With Acute Nonvariceal Upper Gastrointestinal Bleeding." Journal of Clinical Gastroenterology, vol. 47, no. 4, 2013, pp. e33-7.
Del Piano M, Bianco MA, Cipolletta L, et al. The "Prometeo" study: online collection of clinical data and outcome of Italian patients with acute nonvariceal upper gastrointestinal bleeding. J Clin Gastroenterol. 2013;47(4):e33-7.
Del Piano, M., Bianco, M. A., Cipolletta, L., Zambelli, A., Chilovi, F., Di Matteo, G., Pagliarulo, M., Ballarè, M., & Rotondano, G. (2013). The "Prometeo" study: online collection of clinical data and outcome of Italian patients with acute nonvariceal upper gastrointestinal bleeding. Journal of Clinical Gastroenterology, 47(4), e33-7. https://doi.org/10.1097/MCG.0b013e3182617dcc
Del Piano M, et al. The "Prometeo" Study: Online Collection of Clinical Data and Outcome of Italian Patients With Acute Nonvariceal Upper Gastrointestinal Bleeding. J Clin Gastroenterol. 2013;47(4):e33-7. PubMed PMID: 22914349.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The "Prometeo" study: online collection of clinical data and outcome of Italian patients with acute nonvariceal upper gastrointestinal bleeding. AU - Del Piano,Mario, AU - Bianco,Maria Antonia, AU - Cipolletta,Livio, AU - Zambelli,Alessandro, AU - Chilovi,Fausto, AU - Di Matteo,Giovanni, AU - Pagliarulo,Michela, AU - Ballarè,Marco, AU - Rotondano,Gianluca, AU - ,, PY - 2012/8/24/entrez PY - 2012/8/24/pubmed PY - 2013/8/27/medline SP - e33 EP - 7 JF - Journal of clinical gastroenterology JO - J. Clin. Gastroenterol. VL - 47 IS - 4 N2 - GOALS: To implement an online, prospective collection of clinical data and outcome of patients with acute nonvariceal upper gastrointestinal bleeding (UGIB) in Italy ("Prometeo" study). BACKGROUND: Epidemiology, clinical features, and outcomes of nonvariceal UGIB are mainly known by retrospective studies and are probably changing. STUDY: Data were collected by 13 Gastrointestinal Units in Italy from June 2006 to June 2007 (phase 1) and from December 2008 to December 2009 (phase 2): an interim analysis of data was performed between the 2 phases to optimize the online database. All the patients consecutively admitted for acute nonvariceal UGIB were enrolled. Demographic and clinical data were collected, a diagnostic endoscopy performed, with endoscopic hemostasis if indicated. RESULTS: One thousand four hundred thirteen patients (M=932, mean age±SD=66.5±15.8; F=481, mean age±SD=74.2±14.6) were enrolled. Comorbidities were present in 83%. 52.4% were treated with acetyl salicylic acid or other nonsteroidal anti-inflammatory drugs (NSAIDs): only 13.9% had an effective gastroprotection. Previous episodes of UGIB were present in 13.3%. Transfusion were needed in 43.9%. Shock was present in 9.3%. Endoscopic diagnosis was made in 93.2%: peptic lesions were the main cause of bleeding (duodenal ulcer 36.2%, gastric ulcer 29.6%, gastric/duodenal erosions 10.9%). At endoscopy, Helicobacter pylori was searched in 37.2%, and found positive in 51.3% of tested cases. Early rebleeding was observed in 5.4%: surgery was required in 14.3% of them. Bleeding-related death occurred in 4.0%: at multivariate analysis, the risk of death was correlated with female sex [odds ratio (OR=2.19, P=0.0089)], presence of neoplasia (OR=2.70, P=0.0057) or multiple comorbidities (OR=5.04, P=0.0280), shock at admission (OR=4.55, P=0.0001), and early rebleeding (OR=1.47, P=0.004). CONCLUSIONS: Prometeo database has provided an up-to-date picture of acute nonvariceal UGIB in Italy: patients are elderly, predominantly males, and with important comorbidities. Gastroprotection is underutilized during NSAIDs treatment. With respect to previous studies, Prometeo shows a higher incidence of low-dose acetyl salicylic acid use and comorbidities, whereas no significant difference were found in other items (etiology of bleeding, NSAIDs use, need for endoscopic hemostasis, incidence of rebleeding, and overall mortality). SN - 1539-2031 UR - https://www.unboundmedicine.com/medline/citation/22914349/The_"Prometeo"_study:_online_collection_of_clinical_data_and_outcome_of_Italian_patients_with_acute_nonvariceal_upper_gastrointestinal_bleeding_ L2 - http://dx.doi.org/10.1097/MCG.0b013e3182617dcc DB - PRIME DP - Unbound Medicine ER -