Clinical Outcomes and Risk Factors of Rebleeding Following Endoscopic Therapy for Nonvariceal Upper Gastrointestinal Hemorrhage
석기태, 김현수, 이창섭, 이일영, 김문영, 김재우, 백순구, 권상옥, 이동기, 함영림,
소속 상세정보
석기태 ( Suk Ki-Tae )
한림대학교 의과대학 내과학교실
김현수 ( Kim Hyun-Soo )
연세대학교 원주의과대학 내과학교실
이창섭 ( Lee Chang-Seob )
한림대학교 의과대학 내과학교실
이일영 ( Lee Il-Young )
연세대학교 원주의과대학 내과학교실
김문영 ( Kim Moon-Young )
연세대학교 원주의과대학 내과학교실
김재우 ( Kim Jae-Woo )
연세대학교 원주의과대학 내과학교실
백순구 ( Baik Soon-Koo )
연세대학교 원주의과대학 내과학교실
권상옥 ( Kwon Sang-Ok )
연세대학교 원주의과대학 내과학교실
이동기 ( Lee Dong-Ki )
연세대학교 의과대학 내과학교실
함영림 ( Ham Young-Lim )
대원대학교 응급구조학과
KMID : 0359020110440020093
Abstract
Background/Aims: Rebleeding after endoscopic therapy for non-variceal upper gastrointestinal hemorrhage (NGIH) is the most important predictive factor of mortality. We evaluated the risk factors of rebleeding in patients undergoing endoscopic therapy for the NGIH.
Methods: Between January 2003 and January 2007, 554 bleeding events in 487 patients who underwent endoscopic therapy for NGIH were retrospectively enrolled. We reviewed the clinicoendoscopical characteristics of patients with rebleeding and compared them with those of patients without rebleeding.
Results: The incidence of rebleeding was 21.7% (n=120). In the multivariate analysis, initial hemoglobin level ≤9 g/dL (p=0.002; odds ratio [OR], 2.433), inexperienced endoscopist with less than 2 years of experience in therapeutic endoscopy (p=0.001; OR, 2.418), the need for more 15 cc of epinephrine (p=0.001; OR, 2.570), injection therapy compared to thermal and injection therapy (p=0.001; OR, 2.840), and comorbidity with chronic renal disease (p=0.004; OR, 2.908) or liver cirrhosis (p=0.010; OR, 2.870) were risk factors for rebleeding following endoscopic therapy.
Conclusion: Together with patients with low hemoglobin level at presentation, chronic renal disease, liver cirrhosis, the need for more 15 cc of epinephrine, or therapy done by inexperienced endoscopist were risk factors for the development of rebleeding.
키워드
Gastrointestinal hemorrhage; Risk factors; Endoscopy; Therapy
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