Risk factor analysis for early rebleeding in patients with peptic ulcer bleeding

Abstract

Objective To explore the risk factors for early rebleeding in patients with peptic ulcer bleeding (PUB). Methods From June 2006 to May 2017, a total of 1 210 hospitalized patients with PUB from The General Hospital of Ningxia Medical University were enrolled. Totally 1 040 patients with bleeding stopped after the treatment were taken as the control group. And 170 patients with early rebleeding were as the rebleeding group. The clinical data of the patients in two groups were analyzed. Chi-square test, t-test and multivariate factors analysis were performed for statistical analysis. Results Between control group and rebleeding group, there were statistical significances in gender, age, place of residence, hematemesis, shock, volume of blood transfusion, anticoagulant use, combined diseases, hemoglobin level, albumin level, urea nitrogen, neutrophil ratio, platelet count, ulcer location, maximum ulcer diameter, Forrest classification and endoscopic treatment (all P<0.05). The rate of endoscopic hemostasis of rebleeding group (92.56%, 112/121) was lower than that of control group (98.70%, 228/231), and the difference was statistically significant (χ2=13.609, P=0.001). The result of multivariate logistic regression analysis showed that Forrest classification (odds ratio(OR)=7.735, P<0.01), hemoglobin (OR=7.332, P=0.040), shock (OR=5.245, P<0.01) and ulcer size (OR=2.360, P=0.029) were independent risk factors for rebleeding in patients with PUB. The effect of Forrest classification better than hemoglobin, hemoglobin better than shock and shock better than ulcer size in assessing the risk of rebleeding. Conclusions Forrest classification, hemoglobin, shock, ulcer size are the risk factors for rebleeding in patients with PUB. Endoscopic hemostasis can reduce the risk of rebleeding. Key words: Peptic ulcer hemorrhage; Rebleeding; Risk factors