Increased risk of rebleeding of peptic ulcer bleeding in patients with comorbid illness receiving omeprazole infusion
Cheng, H-Chi.; Chuang, S-An.; Kao, Y-Huey.; Kao, A-Wen.; Chuang, C-Hsiung.; Sheu, B-Shyang.
Hepato-Gastroenterology 50(54): 2270-2273
2003
ISSN/ISBN: 0172-6390 PMID: 14696515 Document Number: 554557
Background/Aims: The study aimed to evaluate whether administration of intravenous omeprazole has different rebleeding rates for peptic ulcer bleeding of patients with and without comorbid illness. Methodology: A total of 80 patients with peptic ulcer bleeding were enrolled after therapeutic endoscopy to achieve hemostasis. Each patient had received omeprazole 80mg bolus loading and 40mg twice daily for three days (total dosage of 320mg within 3 days). Two subgroups were divided, based on the absence (Group A) or presence (Group B) of one or more comorbid illnesses, such as chronic obstructive pulmonary disease, congestive heart failure, uremia, cirrhosis, diabetes mellitus, and old stroke. The 7-day and 28-day rebleeding rates were recorded. Results: The presence of comorbid illness had a higher rebleeding rate than those without comorbid illness (7-day: 32.5 vs. 2.5%, p<0.05; 28-day: 37.5 vs. 5.0%, p<0.05). Patients with two or more comorbid diseases had an even higher risk of rebleeding than those with a single comorbid illness (66.7% vs. 26.5%, P<0.05). Conclusions: Low-dose infusion of omeprazole can achieve favorable control of rebleeding in the patients with peptic ulcer bleeding but without comorbid diseases. As patients with comorbid illness had a higher risk of rebleeding, a higher dosage or prolonged duration of omeprazole infusion would be rationally indicated to prevent risk of rebleeding.