title: Bleeding duodenal ulcer. A prospective evaluation of risk factors for rebleeding and death.
abstract: There were 12 hospital deaths in 433 patients (2.8%, 1.6% at 30 days) presenting with bleeding duodenal ulcer. Excluding patients who underwent immediate operation or early elective surgery, where ulcer size was measured at initial endoscopy rebleeding was evident in 40/288 patients (13.9%) and was associated with an increased mortality (0.4% v 12.5%) (p less than 0.0001). Rebleeding rates for ulcers less than or equal to 1 cm and greater than 1 cm were respectively 28/239 (11.7%) and 12/49 (24.5%) (p less than 0.02). Rebleeding occurred in 13/186 patients (7.0%) in whom endoscopic stigmata of recent haemorrhage were absent and in 27/102 (26.5%) with such stigmata (p less than 0.0001). The mortality rate for patients without stigmata was 3/186 (1.6%) whilst mortality figures for patients with ulcers less than or equal to 1 cm and greater than 1 cm in size were respectively 0/77 and 3/25 (12.0%) when stigmata were identified. Ulcers greater than 1 cm were more frequent in the greater than 60 year age group, more likely to have stigmata and carried an increased risk of rebleeding and mortality.
authors.affiliation: Department of Surgery, University of Hong Kong, Queen Mary Hospital.
authors.forename: F J
authors.initials: FJ
authors.lastname: Branicki
authors.forename: J
authors.initials: J
authors.lastname: Boey
authors.forename: P J
authors.initials: PJ
authors.lastname: Fok
authors.forename: C J
authors.initials: CJ
authors.lastname: Pritchett
authors.forename: S T
authors.initials: ST
authors.lastname: Fan
authors.forename: E C
authors.initials: EC
authors.lastname: Lai
authors.forename: F P
authors.initials: FP
authors.lastname: Mok
authors.forename: W S
authors.initials: WS
authors.lastname: Wong
authors.forename: S K
authors.initials: SK
authors.lastname: Lam
authors.forename: W M
authors.initials: WM
authors.lastname: Hui
mesh_terms: D000367:Age Factors; D004381:Duodenal Ulcer / Q000150:complications*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors