Abstract:
AIM:To investigate the long-term prognosis in peptic ulcer patients continuing taking antithrombotics after ulcer bleeding, and to determine the risk factors that influence the prognosis. METHODS:All clinical data of peptic ulcer patients treated from January 1, 2009 to January 1, 2014 were retrospectively collected and analyzed. Patients were divided into either a continuing group to continue taking antithrombotic drugs after ulcer bleeding or a discontinuing group to discontinue antithrombotic drugs. The primary outcome of follow-up in peptic ulcer bleeding patients was recurrent bleeding, and secondary outcome was death or acute cardiovascular disease occurrence. The final date of follow-up was December 31, 2014. Basic demographic data, complications, and disease classifications were analyzed and compared by t- or χ2-test. The number of patients that achieved various outcomes was counted and analyzed statistically. A survival curve was drawn using the Kaplan-Meier method, and the difference was compared using the log-rank test. COX regression multivariate analysis was applied to analyze risk factors for the prognosis of peptic ulcer patients. RESULTS:A total of 167 patients were enrolled into this study. As for the baseline information, differences in age, smoking, alcohol abuse, and acute cardiovascular diseases were statistically significant between the continuing and discontinuing groups (70.8 ± 11.4 vs 62.4 ± 12.0, P < 0.001; 8 (8.2%) vs 15 (21.7%), P < 0.05; 65 (66.3%) vs 13 (18.8%), P < 0.001). At the end of the study, 18 patients had recurrent bleeding and three patients died or had acute cardiovascular disease in the continuing group, while four patients had recurrent bleeding and 15 patients died or had acute cardiovascular disease in the discontinuing group. The differences in these results were statistically significant (P = 0.022, P = 0.000). The Kaplan-Meier survival curve indicated that the incidence of recurrent bleeding was higher in patients in the continuing group, and the risk of death and developing acute cardiovascular disease was higher in patients in the discontinuing group (log-rank test, P = 0.000 for both). Furthermore, COX regression multivariate analysis revealed that the hazard ratio (HR) for recurrent bleeding was 2.986 (95%CI: 067-8.356, P = 0.015) in the continuing group, while HR for death or acute cardiovascular disease was 5.216 (95%CI: 1.035-26.278, P = 0.028). CONCLUSION:After the occurrence of peptic ulcer bleeding, continuing antithrombotics increases the risk of recurrent bleeding events, while discontinuing antithrombotics would increase the risk of death and developing cardiovascular disease. This suggests that clinicians should comprehensively consider the use of antithrombotics after peptic ulcer bleeding.
journal_name
World J Gastroenteroljournal_title
World journal of gastroenterologyauthors
Wang XX,Dong B,Hong B,Gong YQ,Wang W,Wang J,Zhou ZY,Jiang WJdoi
10.3748/wjg.v23.i4.723subject
Has Abstractpub_date
2017-01-28 00:00:00pages
723-729issue
4eissn
1007-9327issn
2219-2840journal_volume
23pub_type
杂志文章abstract::We report a rare case of hypereosinophilic syndrome (HES) presenting with intractable gastric ulcers. A 71-year-old man was admitted with epigastric pain. Initial endoscopic findings revealed multiple, active gastric ulcers in the gastric antrum. He underwent Helicobacter pylori (H pylori) eradication therapy followed...
journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
doi:10.3748/wjg.15.6129
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.v12.i33.5368
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journal_title:World journal of gastroenterology
pub_type: 临床试验,杂志文章
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.3748/wjg.v17.i25.3035
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,meta分析,评审
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更新日期:2006-11-28 00:00:00
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更新日期:2004-02-01 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2008-04-21 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2017-01-21 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.3748/wjg.v7.i3.357
更新日期:2001-06-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,meta分析,评审
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更新日期:2009-10-21 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2010-09-21 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.14.2529
更新日期:2008-04-28 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2010-06-21 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.v26.i32.4833
更新日期:2020-08-28 00:00:00
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pub_type: 评论,信件
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pub_type: 临床试验,杂志文章
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.v8.i2.379
更新日期:2002-04-01 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2009-04-28 00:00:00
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pub_type: 杂志文章
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更新日期:2003-03-01 00:00:00