Continuous intravenous infusion of omeprazole in elderly patients with peptic ulcer bleeding. Results of a placebo-controlled multicenter study.
BACKGROUND
Does profound acid inhibition by continuous infusion of omeprazole for 72 h reduce further bleeding in elderly patients with peptic ulcer bleeding (PUB)?


METHODS
Three hundred and thirty-three patients > or = 60 years old with PUB were randomized to omeprazole (80 mg + mg/h) or placebo as continuous infusion for 72 h. From day 4 to 21 all patients received 20 mg omeprazole orally once daily.


RESULTS
When evaluated on day 3, the primary variable 'overall outcome' (based on an ordinal ranking scale; see Study variables) (P = 0.017) and the secondary variables, surgery (P = 0.003), degree (P = 0.004) and duration of bleeding (P = 0.003) all favored the omeprazole group. Blood transfusions, need for endoscopic treatment, and mortality were not statistically different. On follow-up, by day 21, the mortality in the group initially receiving intravenous omeprazole was 6.9%, while the intravenous placebo group showed an extremely low mortality, 0.6%.


CONCLUSIONS
Three days' infusion of omeprazole improved overall outcome and reduced need for intervention in PUB patients.
Hasselgren
G
G
Dept. of Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.
Lind
T
T
Lundell
L
L
Aadland
E
E
Efskind
P
P
Falk
A
A
Hyltander
A
A
Söderlund
C
C
Eriksson
S
S
Fernström
P
P
D000368:Aged; D000897:Anti-Ulcer Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001803:Blood Transfusion; D004311:Double-Blind Method; D004381:Duodenal Ulcer / Q000150:complications*; D005260:Female; D016558:Hemostasis, Endoscopic; D006801:Humans; D007262:Infusions, Intravenous; D016015:Logistic Models; D008297:Male; D009853:Omeprazole / Q000008:administration & dosage* / Q000627:therapeutic use; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D013276:Stomach Ulcer / Q000150:complications*; D013997:Time Factors; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D009853:Omeprazole