Warning: Undefined variable $zfal in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 525
Deprecated: str_replace(): Passing null to parameter #3 ($subject) of type array|string is deprecated in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 525
Warning: Undefined variable $sterm in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 530
free
Warning: Undefined variable $sterm in C:\Inetpub\vhosts\kidney.de\httpdocs\mlpefetch.php on line 531
free free
English Wikipedia
Nephropedia Template TP (
Twit Text
DeepDyve Pubget Overpricing |
lüll Endoscopic therapy for peptic ulcer hemorrhage: practice variations in a multi-center U S consortium Enestvedt BK; Gralnek IM; Mattek N; Lieberman DA; Eisen GMDig Dis Sci 2010[Sep]; 55 (9): 2568-76BACKGROUND: Peptic ulcer disease is a common cause of acute upper gastrointestinal hemorrhage. The aim of this study was to describe the endoscopic management of bleeding peptic ulcers in a large, U.S. multi-center endoscopic consortium with diverse practice settings. METHODS: Adult patients who underwent upper endoscopy (EGD) for hematemesis, melena or "suspected upper GI bleed" between January 2000 and December 2004 in the Clinical Outcomes Research Initiative (CORI) endoscopic database were screened for the finding of peptic ulcer. The ulcer stigmata, endoscopic therapy and the need for repeat EGD were compared across practice sites. RESULTS: Of 12,392 patients who underwent EGD for an upper gastrointestinal bleeding indication, 3,692 (30%) had at least one peptic ulcer (clean base 59.9%; flat pigmented spot 13.4%; active bleeding 10.7%; clot 7.2%; non-bleeding visible vessel (NBVV) 6.3%). Endoscopic therapy was applied to 93% of actively bleeding ulcers and 95% of NBVV. Repeat endoscopy was required in 7.3% of patients. Ulcers treated with injection monotherapy had the highest repeat EGD rates (12.2%) compared with contact thermal monotherapy (6.1%) and combination thermal/injection therapy (7.1%) (P=0.02). Immediate hemostasis rates were 88-97% across all therapeutic modalities. There was no statistical difference in hemostasis rates across therapy nor practice types. CONCLUSION: In this multi-center consortium, initial hemostasis rates were high across therapy types and sites studied. Injection monotherapy was associated with the highest rates of repeat EGD, supporting guidelines that advise against its use in bleeding peptic ulcers.|*Endoscopy, Gastrointestinal/statistics & numerical data[MESH]|*Hemostasis, Endoscopic/statistics & numerical data[MESH]|*Outcome and Process Assessment, Health Care/statistics & numerical data[MESH]|*Practice Patterns, Physicians'/statistics & numerical data[MESH]|Aged[MESH]|Databases as Topic[MESH]|Female[MESH]|Guideline Adherence[MESH]|Hematemesis/etiology/therapy[MESH]|Humans[MESH]|Male[MESH]|Melena/etiology/therapy[MESH]|Middle Aged[MESH]|Peptic Ulcer Hemorrhage/complications/*therapy[MESH]|Practice Guidelines as Topic[MESH]|Retrospective Studies[MESH]|Treatment Outcome[MESH]|United States[MESH] |