Rebleeding after initial endoscopic hemostasis in peptic ulcer disease

Area of Science:

• Gastroenterology
• Endoscopic procedures
• Hemorrhage control

Background:

• Endoscopic hemostasis is the primary treatment for upper gastrointestinal bleeding (UGIB).
• Risk factors for rebleeding after endoscopic hemostasis are not fully understood, particularly concerning antithrombotic use.
• Peptic ulcer disease (PUD) is a common cause of UGIB requiring endoscopic intervention.

Purpose of the Study:

• To investigate the impact of antithrombotic use on rebleeding rates following successful endoscopic hemostasis for PUD.
• To identify specific factors, including procedure duration, associated with rebleeding after endoscopic hemostasis in PUD patients.

Main Methods:

• Retrospective analysis of 522 patients with PUD who underwent successful endoscopic hemostasis.
• Data collection included patient demographics, antithrombotic use, procedure details, and rebleeding events within 30 days.
• Logistic regression analysis was employed to identify significant predictors of rebleeding.

Main Results:

• The overall rebleeding rate in the study cohort was 17.8% (93 out of 522 patients).
• Aspirin medication and longer endoscopic hemostasis procedure times were significantly associated with increased rebleeding rates.
• Procedure time exceeding 13.5 minutes was a significant independent predictor of rebleeding (Odds Ratio, 2.899; P<0.001).

Conclusions:

• Endoscopic hemostasis duration is a critical factor influencing rebleeding risk in PUD patients.
• Procedures lasting longer than 13.5 minutes are linked to a higher likelihood of rebleeding, even after successful initial hemostasis.
• Further research may explore optimizing endoscopic techniques to minimize procedure time and reduce rebleeding rates.