The Canadian Registry on Nonvariceal Upper Gastrointestinal Bleeding and Endoscopy (RUGBE): Endoscopic Hemostasis and Proton Pump Inhibition are Associated with Improved Outcomes in a Real-Life Setting

• DOI: 10.1111/j.1572-0241.2004.30272.x
• Publication Date: 2004-07-02T14:39:41Z
• Authors: Alan Barkun; Sandrine Sabbah; Robert Enns; David Armstrong; Jamie Gregor; Richard N.N. Fedorak; Elham Rahme; Youssef Toubouti; Myriam Martel; Naoki Chiba; Carlo A. Fallone
• Keywords: Upper Gastrointestinal Bleeding; Gastrointestinal bleeding

OBJECTIVES From the Canadian Registry of patients with Upper Gastrointestinal Bleeding and Endoscopy (RUGBE), we determined clinical outcomes explored roles endoscopic pharmacologic therapies in a contemporary real-life setting. METHODS Analysis randomly selected endoscoped for nonvariceal upper gastrointestinal bleeding at 18 community tertiary care institutions between 1999 2002. Covariates were defined priori 30-day follow-up obtained. Logistic regression models identified predictors outcomes. RESULTS One thousand eight-hundred sixty-nine included (66 ± 17 yr, 38% female, 2.5 1.6 comorbid conditions, hemoglobin, 96 27 g/L, 54% received mean 2.9 1.7 units blood). was performed within 24 h 76%, ulcers (55%) most commonly noted. High-risk stigmata therapy reported 37%. Rebleeding, surgery, mortality rates 14.1%, 6.5%, 5.4%, respectively. Decreased rebleeding significantly independently associated PPI use (85% patients, daily dose 56 53 mg) all regardless stigmata, (odds ratio (OR):0.53, 95% confidence interval, CI:0.37–0.77) hemostasis high-risk (OR:0.39, CI:0.25–0.61). (OR:0.18, CI:0.04–0.80) (OR:0.31, CI:0.11–0.91) also each decreased stigmata. CONCLUSIONS These results appear to confirm protective role suggest that acute PPIs may be reduction lower Independent prospective validation these observational findings is now required.