Increased risk of rebleeding of peptic ulcer bleeding in patients with comorbid illness receiving omeprazole infusion.
OBJECTIVE
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.


METHODS
A total of 80 patients with peptic ulcer bleeding were enrolled after therapeutic endoscopy to achieve hemostasis. Each patient had received omeprazole 80 mg bolus loading and 40 mg twice daily for three days (total dosage of 320 mg 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.
Cheng
Hsiu-Chi
HC
Department of Internal Medicine, Institute of Clinical Medicine, National Cheng Kung University Hospital, 138, Sheng Li Road, Tainan, Taiwan.
Chuang
Sam-An
SA
Kao
Ya-Huey
YH
Kao
Ai-Wen
AW
Chuang
Chiao-Hsiung
CH
Sheu
Bor-Shyang
BS
D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D015897:Comorbidity; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005773:Gastroscopy; D006489:Hemostatic Techniques; D006801:Humans; D007262:Infusions, Intravenous; D008103:Liver Cirrhosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage*; D010438:Peptic Ulcer Hemorrhage / Q000188:drug therapy* / Q000453:epidemiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012307:Risk Factors; D055502:Secondary Prevention; D013624:Taiwan; D017211:Treatment Failure; D014511:Uremia / Q000453:epidemiology
D000897:Anti-Ulcer Agents; D009853:Omeprazole