Epidemiology and adherence to guidelines on the management of bleeding peptic ulcer: a prospective multicenter observational study in 1140 patients.


Serval ID
Article: article from journal or magazin.
Epidemiology and adherence to guidelines on the management of bleeding peptic ulcer: a prospective multicenter observational study in 1140 patients.
Clinics and Research in Hepatology and Gastroenterology
Zeitoun J.D., Rosa-Hézode I., Chryssostalis A., Nalet B., Bour B., Arpurt J.P., Denis J., Nahon S., Pariente A., Hagège H.
Working group(s)
Groupe des Hémorragies Digestives Hautes de l'ANGH
Abdelli N., Antoni M., Arotcarena R., Arpurt JP., Barbare JC., Barbe L., Baron P., Barre V., Bataille L., Baudet P., Becker C., Bellaiche G., Belloc J., Bellon S., Benchaa BA., Benhalima M., Benoit R., Bernard P., Bernardini D., Berthelemy P., Berthelet O., Bicheler V., Blanchi A., Bohon P., Bonnefoy B., Borgeot C., Boruchowicz A., Bottlaender J., Boulay G., Bour B., Bouret JF., Bourhis F., Boutet O., Bouvier J., Boyaval JM., Bramli S., Bremond C., Bresson S., Bretagnolle P., Breysacher G., Brihier H., Butel J., Canva JY., Cassan P., Casteuble D., Charlois T., Chayette C., Cheaib S., Chiappa P., Chinoune F., Cocq-Vezilier P., Colmard P., Combes R., Coquard JL., Costentin L., Coulibaly B., D'abrigeon G., Danisi C., Danne O., Dartois-Hoguin M., Davion T., De Maeght S., de Montigny-Lenhardt S., Delas N., Delatre-Becuwe C., Delhoustal L., Deltenre P., Delvert D., Denis J., Denis B., Desseaux G., Diab G., Djedir R., Doumet S., Duburque C., Duchmann JC., Duffournet V., Dufilhol C., El Braks R., Escudie L., Faroux R., Flamenbaum M., Fleury A., Foutrein MC., Gamblin C., Gayno S., Geagea E., Ghilain JM., Gillot D., Glibert A., Goegebeur G., Gower P., Grasset D., Groleau , Guillaume S., Guillemot F., Gury B., Hagege H., Haioun-Ibrahim N., Heluwaert F., Henrion J., Henriou , Hervio P., Imani K., Janicki E., Jego M., Jomri , Kaassis M., Kerjean A., Khalfoun A., Labayle D., Laberenne JE., Lacherade JC., Lafargue JP., Lagarrigue C., Lambare B., Latrive JP., Laty G., Le Bris M., Le Corguille, Le Dreau G., Le Verger JC. , Lemaire E., Leroy-Doucy M., Lesgourgues B., Ley G., Listrat D., Lons T., Loury-Lariviere I., Macaigne G., Magois-Pilon K., Maisin M., Manet-Lacombe S., Marcato N., Marks-Brunel B., Martin , Messerschmitt C., Medinger G., Messikh G., Monat S., Morin T., Moulart M., Nahon S., Nalet B., Nouel O., Osman H., Ouraghi A., Ozenne V., Pariente A., Paupard T., Pauwels A., Payen JL., Peter A., Picon-Coste M., Pileire G., Pilette C., Pillon D., Prost P., Puech P., Pugelier , Quartier G., Quoic , Rabbia I., Radia-Rakatovao J., Ramadan I., Rambaud S., Ramgoolam B., Ratajczyk S., Remy A J., Richez C., Rierajc , Rocher P., Rosa I., Rossi V., Schapira M., Schnee M., Scribe-Outas M., Seyrig JA., Shekh AL., Shabab N., Slama JL., Soupison A., Tennenbaum R., Tielman G., Tissot B., Tordjman G., Touze I., Vitte RL., Wantiez M., Weiss A M., Wisniewski B., Zavadil P.
2210-741X (Electronic)
Publication state
Issued date
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov'tPublication Status: ppublish. pdf type: Original article
BACKGROUND AND OBJECTIVE: Mortality of upper gastrointestinal bleeding seems declining. Whether practice guidelines for the management of peptic ulcer bleeding are followed is unknown. We aimed to update epidemiology of peptic ulcer bleeding and to assess the adherence to guidelines in the French community.
METHODS: Between March, 2005 and February, 2006, a prospective multicenter study was conducted including all patients with communautary upper gastrointestinal bleeding. Data from patients with peptic ulcer bleeding were extracted and analyzed.
RESULTS: Out of 3203 analyzable patients included, 1140 (35.6%) had a peptic ulcer bleeding and 965 of them a duodenal and/or gastric ulcer. Seven hundred and thirty-five were male (64.5%) and mean age was 66.4 years (±18.8). Overall, 699 patients (61.3%) were taking medication inducing upper gastrointestinal bleeding. Two-hundred and sixty-eight (23.5%) patients had endoscopic therapy, 190 (70.9%) of whom had epinephrine injection alone. Among the 349 patients with high risk stigmata on endoscopy (Forrest IA, IB, IIA), 209 (59.9%) underwent endoscopic therapy. One thousand one hundred and seven patients (97.1%) were given proton-pump inhibitors. One hundred and thirty-four patients (11.8%) experienced haemorrhagic recurrence. Forty-eight patients (4.2%) underwent surgery and 61 (5.4%) died.
CONCLUSIONS: Consistently with previous studies, mortality of upper gastrointestinal bleeding seems declining. Further progress lies above all in prevention but also probably in better adherence to therapeutic guidelines and management of comorbidities.
Aged, Anti-Inflammatory Agents, Non-Steroidal/adverse effects, Endoscopy, Gastrointestinal, Epinephrine/therapeutic use, Female, Guideline Adherence, Helicobacter Infections/epidemiology, Helicobacter pylori, Humans, Male, Peptic Ulcer Hemorrhage/epidemiology, Peptic Ulcer Hemorrhage/therapy, Practice Guidelines as Topic, Prospective Studies, Proton Pump Inhibitors/adverse effects, Recurrence, Thrombosis/epidemiology, Thrombosis/therapy, Vasoconstrictor Agents/therapeutic use
Web of science
Create date
06/12/2013 10:06
Last modification date
20/08/2019 14:07
Usage data