The Use of Higher Dose Steroids Increases the Risk of Rebleeding After Endoscopic Hemostasis for Peptic Ulcer Bleeding

Background Previous studies have shown that several factors such as hemodynamic instability at admission are risk factors for rebleeding of peptic ulcer bleeding. However, whether steroid use increases the risk of rebleeding remains elusive. Aims This study aimed to clarify the risk factors for rebl...

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Bibliographic Details
Published in:Digestive diseases and sciences 2018-11, Vol.63 (11), p.3033-3040
Main Authors: Kondo, Yutaka, Hatta, Waku, Koike, Tomoyuki, Takahashi, Yasushi, Saito, Masahiro, Kanno, Takeshi, Asanuma, Kiyotaka, Asano, Naoki, Imatani, Akira, Masamune, Atsushi
Format: Article
Language:English
Subjects:
Aged
Biochemistry
Comorbidity
Corticosteroids
Dosage and administration
Endoscopy
Female
Gastroenterology
Glucocorticoids - administration & dosage
Glucocorticoids - adverse effects
Health risk assessment
Hemostasis, Endoscopic
Hepatology
Humans
Male
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Middle Aged
Oncology
Original Article
Peptic ulcer
Peptic Ulcer Hemorrhage - chemically induced
Peptic Ulcer Hemorrhage - therapy
Prednisolone
Prednisolone - administration & dosage
Prednisolone - adverse effects
Recurrence
Retrospective Studies
Risk factors
Steroids
Transplant Surgery
Ulcers
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Summary:Background Previous studies have shown that several factors such as hemodynamic instability at admission are risk factors for rebleeding of peptic ulcer bleeding. However, whether steroid use increases the risk of rebleeding remains elusive. Aims This study aimed to clarify the risk factors for rebleeding after endoscopic hemostasis for peptic ulcer bleeding. Methods A total of 185 patients who underwent endoscopic hemostasis for peptic ulcer bleeding at our institution between 2005 and 2017 were retrospectively analyzed. We evaluated factors, including comorbid conditions, in-hospital onset, and steroid use, associated with rebleeding by logistic regression analysis. In addition, we investigated the association between the dose of steroids and rebleeding. Results The rebleeding rate after endoscopic hemostasis for peptic ulcer bleeding was 14.6%. In the multivariate analysis, the independent risk factors for rebleeding were steroid use (odds ratio 4.56, p  = 0.015), multiple ulcers (4.43, p  = 0.005), number of comorbidities ≥ 3 3.18, p  = 0.026), hemodynamic instability (3.06, p  = 0.039), and number of comorbidities ≥ 3 (2.93, p  = 0.047). Furthermore, the use of higher dose steroids (≥ 20 mg per day in prednisolone; 10.55, p  = 0.002), but not lower dose (
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-018-5209-y