|
Despite advances in endoscopic and pharmacological treatment for peptic ulcer bleeding, mortality remains at 5–10% worldwide.
Dr Joseph Sung and colleagues from Hong Kong investigated the causes of death in a prospective cohort of peptic ulcer bleeding in a tertiary referral center.
The team registered all patients with upper gastrointestinal bleeding admitted to the Prince of Wales Hospital between 1993 and 2005.
Demographic data, characteristics of ulcer, and pharmacological, endoscopic, and surgical therapy, were documented.
Mortality cases were classified as bleeding-related death or non-bleeding-related death.
 | | Most bleeding-related deaths occurred when immediate control of bleeding failed | | American Journal of Gastroenterology |
The researchers enrolled in all, 18,508 cases of upper gastrointestinal bleeding.
Of these, 10,428 cases from 9,375 patients were confirmed to have peptic ulcer bleeding, and 6% patients died.
There were significantly more patients who died of non-ulcer bleeding causes than bleeding causes.
The team found that the mean age of those who died of bleeding-related causes was higher than that of those who died of non-bleeding causes.
Most bleeding-related deaths occurred when immediate control of bleeding failed or when patients died within 48 hours after endoscopic therapy.
Among those who died of non-bleeding-related causes, the team found that multiorgan failure, pulmonary conditions, and terminal malignancy were most common.
Dr Sung's team concluded, “The majority of peptic ulcer bleeding patients died of non-bleeding-related causes.”
“Optimization of management should aim at reducing the risk of multiorgan failure and cardiopulmonary death instead of focusing merely on successful hemostasis.”
| 
Email this page to a colleague
