The Effect of Using Preendoscopic Proton Pump Inhibitors in Upper Gastrointestinal System Bleeding on Patient Prognosis

Completed

• Conditions: Upper Gastrointestinal Bleeding, Proton Pump Inhibitors

• Registration Number: NCT05467358
• Lead Sponsor: Ankara City Hospital Bilkent

Brief Summary

In this study, we aimed to investigate the effectiveness of ppi use in upper gastrointestinal bleeding in patients over the age of 18 who underwent endoscopy on mortality, length of hospital stay, rebleeding, and cost. The European Society of Gastrointestinal Endoscopy 2021 recommends the use of preendoscopic ppi in patients with nonvariceal upper gastrointestinal bleeding as it reduces the need for endoscopic treatment. This recommendation is recommended by the British Institute for Health and Care Excellence not to use proton pump inhibitors. Likewise, the 2021 American Gastroenterology Association did not make a recommendation for its use because the benefit of using preendoscopic ppi is uncertain. This has led to confusion about the efficacy of ppi and has questioned the necessity of routinely given high-dose ppi therapy. In this study, we aim to reveal the effectiveness of the treatment by comparing the patients who were given and not given ppi. Our research is a retrospective cohort study. Patients over the age of 18 who applied to the emergency department and had a preliminary diagnosis of upper gastrointestinal bleeding and underwent endoscopy will be included in the study. Patients who underwent endoscopy and were given ppi and those who were not will be compared. In upper gastrointestinal bleeding, patients with a Glasgow Blatchford score of 2 and above are taken to endoscopy. Therefore, patients over the age of 18 who underwent endoscopy will be included in the study.

Detailed Description

Due to the problems experienced in the supply of ppi, ppi was not available in our hospital for a while. Therefore, ppi could not be given to the patients. It was started to be given after the drug was re-supplied. In our study, we retrospectively analyzed patients who could and could not receive ppi. The data of the patients were as follows: age, gender, complaints on admission, known diseases, vital signs, medications used, rectal examination, whole blood parameters, biochemistry parameters, Glasgow Blatchford scores, endoscopy results, whether they received blood products, how much of each product they received, emergency We recorded service outcomes and emergency room costs.

Study Timeline

• Study Start: 2021-07-01
• Primary Completion: 2022-03-01
• Study First Submitted: 2022-06-17
• Status Verified: 2022-07
• Study First Submitted QC: 2022-07-18
• Study First Posted: 2022-07-20
• Study Completion: 2023-01-01
• Last Update Submitted: 2023-09-26
• Last Update Posted: 2023-09-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1100

Inclusion Criteria

• having an endoscopy at the time of admission to the emergency room
• Glasgow Blatchford score of 2 or higher
• be over 18 years old

Exclusion Criteria

• patients who do not meet the inclusion criteria will be excluded

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Need for repeat endoscopy	7 days	Bleeding associated need for reoperation
mortality	28 days	illness related death
cost of transactions	through study completion, an average of 1 year	health expenditure during hospital stay
hospital stay time	through study completion, an average of 1 year	hospitalization day

Trial Locations

Locations (1)

Ankara Bilkent Şehir Hastanesi; 🇹🇷 Ankara, Turkey