Risk Factors and Rate of Rebleeding in Patients with Bleeding Peptic Ulcers

Seo, Seung Won; Kim, Yeon Soo; Mun, Hee Seok; Park, Ki Ho; Lee, Eom Seok; Kim, Seon Mun; Yang, Hyeon Woong; La, Byung Kyu; Seong, Jae Kyu; Lee, Byung Seok; Jeong, Hyun Yong

Abstract

BACKGROUND/AIMS: Bleeding from peptic ulcer is a common and serious complication. Endoscopic therapy is effective in hemostasis of active bleeding. However, rebleeding occurs in 10-30% of patients with bleeding peptic ulcer, and is an important factor associated with mortality. In this study, we analyzed risk factors and rate of rebleeding in patients with bleeding peptic ulcer.
METHODS
We analyzed 194 patients with peptic ulcer bleeding between June 1995 and May 1998. We retrospectively analyzed the rebleeding risk factors by reviewing medical records and telephone interviews.
RESULTS
Rebleeding of peptic ulcer occurred in 43 patients (22.2%). Cumulative rebleeding rate was 12.1% after 1 month, 15.2% after 6 months. The cumulative rebleeding rates at 1, 2, and 3 years were 16.2%, 19.4% and 20.9%, respectively. On the basis of an univariate analysis of clinical and endoscopic findings, significant predictive factors for rebleeding were history of peptic ulcer bleeding (p=0.002), use of NSAIDs (p=0.08), endoscopic stigmata of recent hemorrhage (p=0.000), and presence of shock (p=0.002). In multivariate analysis, history of peptic ulcer bleeding (odds ratio, OR=9.12), use of NSAIDs (OR=7.91), endoscopic stigmata of recent hemorrhage (OR=0.37), and presence of shock (OR=3.83) were independent risk factors of rebleeding.
CONCLUSIONS
Rebleeding rate of peptic ulcer is 20.6% during 3 years of follow-up and important risk factors of rebleeding are history of peptic ulcer bleeding, use of NSAIDs, endoscopic stigmata of recent hemorrhage, and presence of shock.