Does Adding Somatostatin to Proton Pump Inhibitor Improve the Outcome of Peptic Ulcer Bleeding?.
10.4266/kjccm.2008.23.2.75
- Author:
Insung KIM
1
;
Yoon Seon LEE
;
Byuk Sung KOH
;
Won KIM
;
Kyoung Soo LIM
Author Information
1. Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. kslim@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
hemorrhage;
peptic ulcer;
proton pump inhibitors;
somatostatin
- MeSH:
Erythrocytes;
Hemorrhage;
Hemostasis, Endoscopic;
Hospital Mortality;
Humans;
Imidazoles;
Length of Stay;
Nitro Compounds;
Peptic Ulcer;
Proton Pump Inhibitors;
Proton Pumps;
Protons;
Somatostatin
- From:The Korean Journal of Critical Care Medicine
2008;23(2):75-78
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Somatostatin has been shown to offer a distinct advantage over antisecretory drugs in the management of peptic ulcer bleeding (PUB). However, rebleeding rates are still high in spite of endoscopic and medical treatment. In this study, we intended to determine whether combined therapy of a proton pump inhibitor (PPI) plus somatostatin is more beneficial than a PPI alone in patients with PUB. METHODS: We enrolled 90 consecutive patients who presented with PUB between January 2006 and October 2007. All the patients were managed with endoscopic hemostasis and divided into two treatment groups: 1) PPI alone (group A) and 2) PPI plus somatostatin (group B). The primary outcome was rebleeding within 72 hours. The secondary outcomes were rebleeding in 30 days, packed red blood cells (pRBC) transfused, length of hospital stay, need for surgery, and in-hospital mortality. RESULTS: Forty-five patients in the PPI group (A) and 45 patients in the PPI plus somatostatin group (B) were studied. There was no difference between the two groups with respect to clinical and endoscopic features at admission. After medical treatment, there was no difference between groups A and B in rebleeding at 72 hours (11% vs. 13%, p = NS), rebleeding in 30 days (13% vs. 16%, p = NS), pRBC transfused (mean, 3.2 vs. 4.5 units, p = NS), length of hospital stay (mean, 7.4 vs. 8.4 days, p = NS), and in-hospital mortality (2% vs. 7%, p = NS). CONCLUSIONS: Combined therapy with PPI and somatostatin did not result in better outcomes than PPI alone.
