title: Factors predicting incomplete endoscopic hemostasis in bleeding gastroduodenal ulcers.
abstract: OBJECTIVE
  To investigate the factors contributing to failure of initial hemostasis in patients undergoing endoscopic hemostasis.
  
  
  METHODS
  A total of 316 patients underwent endoscopic hemostasis for bleeding peptic ulcers in a period of 4 years.
  
  
  RESULTS
  For hemostatic procedures, application of hemostatic clips, band ligation, injection of hypertonic saline epinephrine solution, soft coagulation, and argon plasma coagulation were employed either singly or in combination. Patients were divided into the following 2 groups for multivariate analysis: durable hemostasis (n = 268) and failed initial (incomplete) hemostasis (n = 48). Hemodialysis was a risk factor of incomplete hemostasis (Odds Ratio [OR] = 2.306, 95% confidence interval [CI] = 1.033-5.147; p = 0.041). Compared with the duodenal 2nd portion, the following bleeding sites had significantly lower risk of incomplete hemostasis (approximately 5 times less likely): The duodenal bulb (D), OR = 0.215, 95% CI = 0.058-0.797 (p = 0.022); the L region, OR = 0.207, 95% CI = 0.046-0.919 (p = 0.038); the M region, OR = 0.132, 95% CI = 0.036-0.482 (p = 0.002); and the U region, OR = 0.164, 95% CI = 0.041-0.649 (p = 0.01). CONCLUSIONn: Hemodialysis and a bleeding site located in the duodenal second portion were the factors strongly associated with incomplete hemostasis in bleeding gastroduodenal ulcers.
authors.affiliation: Department of Gastroenterology, Kokura Memorial Hospital, 1-1 kifune-machi, Kokurakita-ku, kitakyushu, Fukuoka 802-8555, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Urayama
authors.forename: Kei
authors.initials: K
authors.lastname: Shiraishi
authors.forename: Koji
authors.initials: K
authors.lastname: Aoyama
authors.forename: Kenji
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Kaoru
authors.initials: K
authors.lastname: Omori
authors.forename: Sohji
authors.initials: S
authors.lastname: Nishina
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Saiki
authors.forename: Noboru
authors.initials: N
authors.lastname: Kojima
authors.forename: Atsuyoshi
authors.initials: A
authors.lastname: Hirano
authors.forename: Makoto
authors.initials: M
authors.lastname: Nishiaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Okita
authors.forename: Kouki
authors.initials: K
authors.lastname: Yutoku
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Kubo
authors.forename: Noboru
authors.initials: N
authors.lastname: Maetani
authors.forename: Yozo
authors.initials: Y
authors.lastname: Iida
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Odawara
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yoshida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000009:adverse effects; D005260:Female; D016558:Hemostasis, Endoscopic / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010438:Peptic Ulcer Hemorrhage / Q000628:therapy*; D012307:Risk Factors
chemical_list: D001241:Aspirin