The Role of History of Gastro-Duodenal Ulcer in Patients with Upper Gastrointestinal Bleeding

Yusaku Takatori, Motohiko Kato, Yukie Sunata, Yuichiro Hirai, Yoko Kubosawa, Keichiro Abe, Yoshiaki Takada, Tetsu Hirata, Shigeo Banno, Michiko Wada, Satoshi Kinoshita, Hideki Mori, Kaoru Takabayashi, Miho Kikuchi, Masahiro Kikuchi, Masayuki Suzuki, Toshio Uraoka

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4 Citations (Scopus)

Abstract

Background: Some scoring systems have been introduced to predict the need for performing urgent endoscopy in patients with upper gastrointestinal bleeding (UGIB). However, in an emergency situation, this intervention is insufficient and cannot easily provide the required treatment. Aim: To identify new risk factors that can predict the need for endoscopic intervention (EI) in UGIB patients. Methods: This is a retrospective cross-sectional study. Patients with UGIB admitted from April 2011 to August 2014 were included. The proportion of cases requiring EI and clinical factors (age, gender, antiplatelet/anticoagulant therapy, history of gastro-duodenal ulcer (GDU), systolic blood pressure, heart rate, hemoglobin, mean corpuscular volume, blood urea nitrogen-creatinine ratio (BUN/Cr ratio), prothrombin time-international normalized ratio, and Glasgow-Blatchford Score (GBS) were analyzed using logistic regression models. Result: Of 378 patients who were included in this study, 180 were found to be with GDU. The proportion of cases requiring EI was significantly higher in those with GDU than in other causes except variceal bleeding (53.5 vs. 37.0%, p < 0.01). Multivariate analysis revealed that a history of GDU was an independent risk factor (OR 1.78, 95% CI 1.06–3.00) in addition to BUN/Cr ratio (OR 1.02, 95% CI 1.00–1.03) and GBS (OR 1.19, 95% CI 1.08–1.33). Conclusion: A history of GDU was an independent risk factor for predicting the need for EI in UGIB in addition to BUN/Cr ratio and GBS.

Original languageEnglish
JournalDigestive Diseases
DOIs
Publication statusAccepted/In press - 2018 Jan 17
Externally publishedYes

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Keywords

  • Endoscopic intervention
  • Gastroduodenal ulcer
  • Risk factor
  • Upper gastrointestinal bleeding

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Takatori, Y., Kato, M., Sunata, Y., Hirai, Y., Kubosawa, Y., Abe, K., Takada, Y., Hirata, T., Banno, S., Wada, M., Kinoshita, S., Mori, H., Takabayashi, K., Kikuchi, M., Kikuchi, M., Suzuki, M., & Uraoka, T. (Accepted/In press). The Role of History of Gastro-Duodenal Ulcer in Patients with Upper Gastrointestinal Bleeding. Digestive Diseases. https://doi.org/10.1159/000486234