Daily Usage of Proton Pump Inhibitors May Reduce the Severity of Critical Upper Gastrointestinal Bleeding in Elderly Patients
Introduction. We retrospectively examined the relationship between daily proton pump inhibitor (PPI) use and severity of upper gastrointestinal bleeding (UGIB), mainly in the elderly. Methods. We included 97 patients with nonvariceal UGIB diagnosed at our hospital from January 2012 to October 2017....
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2020/7168621 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832551705828392960 |
|---|---|
| author | Hidetaka Matsuda Takuto Nosaka Yu Akazawa Yasushi Saito Yoshihiko Ozaki Kazuto Takahashi Tatsushi Naito Kazuya Ofuji Masahiro Ohtani Katsushi Hiramatsu Yasunari Nakamoto |
| author_facet | Hidetaka Matsuda Takuto Nosaka Yu Akazawa Yasushi Saito Yoshihiko Ozaki Kazuto Takahashi Tatsushi Naito Kazuya Ofuji Masahiro Ohtani Katsushi Hiramatsu Yasunari Nakamoto |
| author_sort | Hidetaka Matsuda |
| collection | DOAJ |
| description | Introduction. We retrospectively examined the relationship between daily proton pump inhibitor (PPI) use and severity of upper gastrointestinal bleeding (UGIB), mainly in the elderly. Methods. We included 97 patients with nonvariceal UGIB diagnosed at our hospital from January 2012 to October 2017. Bleeding severity was assessed using the shock index (SI) and estimated bleeding volume; 49 patients met the criterion for the mild group and 48 for the moderate/severe group. The effect of PPI use on bleeding severity was compared between the groups. The relationships of PPI use and dose with the clinical symptoms of UGIB were also analyzed. Results. Among the 97 patients, 17 (17.5%) habitually used PPIs. The rate of habitual PPI use was significantly higher in the mild group, indicating as an independent factor contributing to a reduction in the severity of UGIB in a multiple logistic regression analysis (30.6% vs. 4.2%; OR 10.147; 95% CI 2.174–47.358, P<0.01). When analyzing data for a subgroup of patients older than 75 years, we found the protective PPI effect to be even higher in the mild UGIB group than in the moderate/severe group (37.0% vs. 5.6%; OR 10.000; 95% CI 1.150–86.951, P<0.05). Conversely, we found no association between PPI prescription and UGIB symptoms in patients younger than 75 years. The mean estimated bleeding volume and SI in the 17 habitual PPI users were both significantly less than those among the 80 nonhabitual users, respectively (P<0.05). The proportion of patients with mild UGIB was similar between the low- and high-dose PPI users. Conclusions. Particularly in elderly patients with nonvariceal UGIB, habitual PPI use can alleviate the clinical symptoms of UGIB by suppressing the volume of bleeding, regardless of the adapted dose of PPIs. |
| format | Article |
| id | doaj-art-e3936d13ea8e4bdeab5f3ebcf5282e40 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-e3936d13ea8e4bdeab5f3ebcf5282e402025-02-03T06:00:49ZengWileyGastroenterology Research and Practice1687-61211687-630X2020-01-01202010.1155/2020/71686217168621Daily Usage of Proton Pump Inhibitors May Reduce the Severity of Critical Upper Gastrointestinal Bleeding in Elderly PatientsHidetaka Matsuda0Takuto Nosaka1Yu Akazawa2Yasushi Saito3Yoshihiko Ozaki4Kazuto Takahashi5Tatsushi Naito6Kazuya Ofuji7Masahiro Ohtani8Katsushi Hiramatsu9Yasunari Nakamoto10Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, JapanSecond Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, JapanSecond Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, JapanSecond Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, JapanSecond Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, JapanSecond Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, JapanSecond Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, JapanSecond Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, JapanSecond Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, JapanSecond Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, JapanSecond Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, JapanIntroduction. We retrospectively examined the relationship between daily proton pump inhibitor (PPI) use and severity of upper gastrointestinal bleeding (UGIB), mainly in the elderly. Methods. We included 97 patients with nonvariceal UGIB diagnosed at our hospital from January 2012 to October 2017. Bleeding severity was assessed using the shock index (SI) and estimated bleeding volume; 49 patients met the criterion for the mild group and 48 for the moderate/severe group. The effect of PPI use on bleeding severity was compared between the groups. The relationships of PPI use and dose with the clinical symptoms of UGIB were also analyzed. Results. Among the 97 patients, 17 (17.5%) habitually used PPIs. The rate of habitual PPI use was significantly higher in the mild group, indicating as an independent factor contributing to a reduction in the severity of UGIB in a multiple logistic regression analysis (30.6% vs. 4.2%; OR 10.147; 95% CI 2.174–47.358, P<0.01). When analyzing data for a subgroup of patients older than 75 years, we found the protective PPI effect to be even higher in the mild UGIB group than in the moderate/severe group (37.0% vs. 5.6%; OR 10.000; 95% CI 1.150–86.951, P<0.05). Conversely, we found no association between PPI prescription and UGIB symptoms in patients younger than 75 years. The mean estimated bleeding volume and SI in the 17 habitual PPI users were both significantly less than those among the 80 nonhabitual users, respectively (P<0.05). The proportion of patients with mild UGIB was similar between the low- and high-dose PPI users. Conclusions. Particularly in elderly patients with nonvariceal UGIB, habitual PPI use can alleviate the clinical symptoms of UGIB by suppressing the volume of bleeding, regardless of the adapted dose of PPIs.http://dx.doi.org/10.1155/2020/7168621 |
| spellingShingle | Hidetaka Matsuda Takuto Nosaka Yu Akazawa Yasushi Saito Yoshihiko Ozaki Kazuto Takahashi Tatsushi Naito Kazuya Ofuji Masahiro Ohtani Katsushi Hiramatsu Yasunari Nakamoto Daily Usage of Proton Pump Inhibitors May Reduce the Severity of Critical Upper Gastrointestinal Bleeding in Elderly Patients Gastroenterology Research and Practice |
| title | Daily Usage of Proton Pump Inhibitors May Reduce the Severity of Critical Upper Gastrointestinal Bleeding in Elderly Patients |
| title_full | Daily Usage of Proton Pump Inhibitors May Reduce the Severity of Critical Upper Gastrointestinal Bleeding in Elderly Patients |
| title_fullStr | Daily Usage of Proton Pump Inhibitors May Reduce the Severity of Critical Upper Gastrointestinal Bleeding in Elderly Patients |
| title_full_unstemmed | Daily Usage of Proton Pump Inhibitors May Reduce the Severity of Critical Upper Gastrointestinal Bleeding in Elderly Patients |
| title_short | Daily Usage of Proton Pump Inhibitors May Reduce the Severity of Critical Upper Gastrointestinal Bleeding in Elderly Patients |
| title_sort | daily usage of proton pump inhibitors may reduce the severity of critical upper gastrointestinal bleeding in elderly patients |
| url | http://dx.doi.org/10.1155/2020/7168621 |
| work_keys_str_mv | AT hidetakamatsuda dailyusageofprotonpumpinhibitorsmayreducetheseverityofcriticaluppergastrointestinalbleedinginelderlypatients AT takutonosaka dailyusageofprotonpumpinhibitorsmayreducetheseverityofcriticaluppergastrointestinalbleedinginelderlypatients AT yuakazawa dailyusageofprotonpumpinhibitorsmayreducetheseverityofcriticaluppergastrointestinalbleedinginelderlypatients AT yasushisaito dailyusageofprotonpumpinhibitorsmayreducetheseverityofcriticaluppergastrointestinalbleedinginelderlypatients AT yoshihikoozaki dailyusageofprotonpumpinhibitorsmayreducetheseverityofcriticaluppergastrointestinalbleedinginelderlypatients AT kazutotakahashi dailyusageofprotonpumpinhibitorsmayreducetheseverityofcriticaluppergastrointestinalbleedinginelderlypatients AT tatsushinaito dailyusageofprotonpumpinhibitorsmayreducetheseverityofcriticaluppergastrointestinalbleedinginelderlypatients AT kazuyaofuji dailyusageofprotonpumpinhibitorsmayreducetheseverityofcriticaluppergastrointestinalbleedinginelderlypatients AT masahiroohtani dailyusageofprotonpumpinhibitorsmayreducetheseverityofcriticaluppergastrointestinalbleedinginelderlypatients AT katsushihiramatsu dailyusageofprotonpumpinhibitorsmayreducetheseverityofcriticaluppergastrointestinalbleedinginelderlypatients AT yasunarinakamoto dailyusageofprotonpumpinhibitorsmayreducetheseverityofcriticaluppergastrointestinalbleedinginelderlypatients |