Related Experiment Video
Updated: Jun 28, 2026
03:05
Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia
Published on: February 16, 2024
Predicting mortality in patients with bleeding peptic ulcers after therapeutic endoscopy
Philip W Y Chiu1, Enders K W Ng, Frances K Y Cheung
1Department of Surgery, Institute of Digestive Disease, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong. philipchiu@surgery.cuhk.edu.hk
Summary
Predicting mortality in bleeding peptic ulcers is crucial. Advanced age, comorbidities, shock, and rebleeding are key indicators, enabling better patient management and improved outcomes.
Area of Science:
- Gastroenterology
- Internal Medicine
- Clinical Research
Background:
- Bleeding peptic ulcers remain a significant cause of mortality, with rates around 10% despite advances in management.
- Identifying factors that predict mortality is essential for improving patient outcomes.
Purpose of the Study:
- To identify predictive factors for mortality in patients with bleeding peptic ulcers.
- To develop and validate a prediction model for in-hospital mortality in this patient group.
Main Methods:
- A cohort of 3220 patients with bleeding peptic ulcers was analyzed.
- Multiple stepwise logistic regression was used to identify risk factors for mortality.
- A prediction model was developed and validated in a prospective cohort.
Main Results:
- In-hospital mortality was 7.1% in the initial cohort.
- Significant predictors of mortality included advanced age (>70 years), comorbidity, hematemesis, low systolic blood pressure, in-hospital bleeding, rebleeding, and need for surgery.
- The developed model demonstrated good predictive accuracy (AUC 0.842 in derivation, 0.729 in validation).
Conclusions:
- Advanced age, comorbidities, hypovolemic shock, in-hospital bleeding, rebleeding, and need for surgery are strong predictors of in-hospital mortality.
- The developed prediction model can aid in risk stratification and management of patients with bleeding peptic ulcers.
Related Concept Videos
01:27Peptic Ulcer
Peptic ulcers are erosive lesions of the gastric or duodenal lining, most commonly caused by Helicobacter pylori infection. This Gram-negative, helical bacterium has adapted to survive the stomach’s acidic environment by producing urease, which converts urea into ammonia and carbon dioxide. The ammonia neutralizes gastric acid in the bacterium’s immediate environment, allowing colonization of the gastric mucosa. H. pylori attaches to mucus-secreting epithelial cells, penetrates the mucus...
01:25Peptic Ulcer Disease III: Clinical Manifestations and Complications
Duodenal UlcersDuodenal ulcers are the most common form of peptic ulcer disease, presenting with chronic, intermittent epigastric pain. Pain typically appears 2–3 hours after meals, especially when the stomach is empty, often waking patients at night. It is characteristically relieved by food or antacids (“pain–food–relief”). Some patients remain asymptomatic until complications like bleeding or perforation emerge, particularly with NSAID or anticoagulant use.Gastric UlcersGastric ulcers share...
01:26Peptic Ulcer Disease IV: Management
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current medication...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current medication...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
01:30Peptic Ulcer Disease I: Introduction
Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...