title: Risk Factors Associated with Rebleeding in Patients with High Risk Peptic Ulcer Bleeding: Focusing on the Role of Second Look Endoscopy.
abstract: BACKGROUND
  Re-bleeding after initial hemostasis in peptic ulcer bleeding can be life threatening. Identification of factors associated with re-bleeding is important. The aims of this study were to determine incidence of rebleeding in patients with high risk peptic ulcer bleeding and to evaluate factors associated with rebleeding.
  
  
  METHODS
  Among patients diagnosed as upper gastrointestinal hemorrhage at seven hospitals in Daegu-Gyeongbuk, and one hospital in Gyeongnam, South Korea, from Feb 2011 to Dec 2013, 699 patients diagnosed as high risk peptic ulcer bleeding with Forrest classification above llb were included. The data were obtained in a prospective manner.
  
  
  RESULTS
  Among 699 patients, re-bleeding occurred in 64 (9.2 %) patients. Second look endoscopy was significantly more performed in the non-rebleeding group than the rebleeding group (81.8 vs 62.5 %, p < 0.001). In multivariate analysis, use of non-steroidal anti-inflammatory agents, larger transfusion volume (≥5 units), and non-performance of second look endoscopy were found as risk factors for rebleeding in high risk peptic ulcer bleeding.
  
  
  CONCLUSIONS
  In our study, rebleeding was observed in 9.2 % of patients with high risk peptic ulcer bleeding. Performance of second look endoscopy seems to lower the risk of rebleeding in high risk peptic ulcer bleeding patients and caution should be paid to patients receiving high volume transfusion and on medication with NSAIDs.
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, 705-703, Republic of Korea.
authors: Sung Bum
authors: SB
authors: Kim
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, 705-703, Republic of Korea. dr9696@nate.com.
authors: Si Hyung
authors: SH
authors: Lee
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, 705-703, Republic of Korea.
authors: Kyeong Ok
authors: KO
authors: Kim
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, 705-703, Republic of Korea.
authors: Byung Ik
authors: BI
authors: Jang
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1 Daemyung-dong, Nam-gu, 705-703, Republic of Korea.
authors: Tae Nyeun
authors: TN
authors: Kim
authors: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors: Seong Woo
authors: SW
authors: Jeon
authors: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.
authors: Joong Goo
authors: JG
authors: Kwon
authors: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.
authors: Eun Young
authors: EY
authors: Kim
authors: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.
authors: Jin Tae
authors: JT
authors: Jung
authors: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea.
authors: Kyung Sik
authors: KS
authors: Park
authors: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea.
authors: Kwang Bum
authors: KB
authors: Cho
authors: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea.
authors: Eun Soo
authors: ES
authors: Kim
authors: Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Republic of Korea.
authors: Hyun Jin
authors: HJ
authors: Kim
authors: Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea.
authors: Chang Keun
authors: CK
authors: Park
authors: Department of Internal Medicine, Dongguk University School of Medicine, Daegu, Republic of Korea.
authors: Jeong Bae
authors: JB
authors: Park
authors: Department of Internal Medicine, Dongguk University School of Medicine, Daegu, Republic of Korea.
authors: Chang Heon
authors: CH
authors: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016145:Endoscopy, Digestive System; D005260:Female; D016558:Hemostasis, Endoscopic; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000517:prevention & control* / Q000628:therapy; D012008:Recurrence; D012307:Risk Factors; D024162:Second-Look Surgery; D055815:Young Adult
keywords: Blood transfusion; Duodenal ulcer; Rebleeding; Second look endoscopy; Stomach ulcer