Prediction of therapeutic failure after adrenaline injection plus heater probe treatment in patients with bleeding peptic ulcer

S K H Wong ¹, L-M Yu , J Y W Lau

⁰Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.

Gut +

|

February 13, 2002

View abstract on PubMed

Summary

Recurrent bleeding after endoscopic ulcer treatment is a serious risk. Large ulcers and active bleeding at presentation are key factors predicting treatment failure, guiding future interventions.

Area Of Science

Gastroenterology
Endoscopic therapeutics
Gastrointestinal bleeding

Background

Recurrent bleeding after endoscopic treatment for bleeding ulcers is a significant negative prognostic indicator.
Identifying high-risk ulcers can inform alternative treatment strategies.

Purpose Of The Study

To identify factors that predict treatment failure in patients undergoing combined adrenaline injection and heater probe thermocoagulation for bleeding peptic ulcers.

Main Methods

A prospective study of consecutive patients with bleeding peptic ulcers treated endoscopically between 1995 and 1998.
Data collected included clinical presentation, endoscopic findings, and treatment outcomes.
Multiple logistic regression analysis was employed to determine independent risk factors for treatment failure.

Main Results

Initial hemostasis was achieved in 98.6% of 1144 treated patients; however, 8.2% rebled.
Independent predictors of rebleeding included hypotension, low hemoglobin levels (<10 g/dl), fresh blood in the stomach, active ulcer bleeding, and large ulcer size.
The overall treatment failure rate was 9.6%, with a 5% mortality rate.

Conclusions

Larger ulcer size and severe bleeding at the time of endoscopic presentation are significant predictors of treatment failure.
These findings can help stratify risk and guide management decisions for bleeding peptic ulcers.

Related Concept Videos