SynthesisCanadian journal of gastroenterology & hepatology2014
Timing of rebleeding in high-risk peptic ulcer bleeding after successful hemostasis: a systematic review.
Synthesis in Canadian journal of gastroenterology & hepatology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 29 citations in OpenAlex.
- Endoscopic Application of Tranexamic Acid and Sucralfate in Upper Gastrointestinal Bleeding: A Randomized Controlled Trial.Clinical and translational gastroenterology · 2026Trial
- Use of the self-assembling peptide (PuraStat™) for the management and prevention of ERCP-related bleeding: a multicenter prospective cohort study.Surgical endoscopy · 2026Observational
- Safety of long vs. short fasting after ESD/STER for esophageal tumors ≤ 2 cm: a propensity score-matching study.BMC gastroenterology · 2025Article
- Risk factors for peptic ulcer bleeding one year after the initial episode.Gut pathogens · 2024Article
- Clinical Outcomes of Patients with Benign Peptic Ulcer Bleeding After an Emergency Endoscopy Based on Patient Location.Digestive diseases and sciences · 2023Article
- Platelet Aggregation Inhibitors and Anticoagulants in Gastroenterological and Visceral Surgical Procedures.Deutsches Arzteblatt international · 2022Review
- Endoscopic treatment modalities and outcomes in nonvariceal upper gastrointestinal bleeding.World journal of gastrointestinal endoscopy · 2020Article
- Recent trends in the occurrence of bleeding gastric and duodenal ulcers under the Japanese evidence-based clinical practice guideline for peptic ulcer disease.JGH open : an open access journal of gastroenterology and hepatology · 2018Article
- Once Versus Twice-Daily Oral Proton Pump Inhibitor Therapy for Prevention of Peptic Ulcer Rebleeding: A Propensity Score-Matched Analysis.Gastroenterology research · 2018Article
- Simple diverticulectomy is adequate for management of bleeding Meckel diverticulum.Pediatric surgery international · 2018Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPeptic ulcer rebleeding (PUR) usually occurs within three days following endoscopic hemostasis. However, recent data have increasingly suggested delayed rebleeding.
objectiveTo better characterize the timing of PUR (Forrest Ia to IIb) following initially successful endoscopic hemostasis.
methodsAn exhaustive literature search (1989 to 2013), with cross-referencing, was performed to identify pertinent randomized controlled trial (RCT) arms. Patients receiving high-dose proton pump inhibitor (PPI) infusion following successful modern-day endoscopic hemostasis were included. A sensitivity analysis included any patients receiving PPI doses >40 mg daily. The main outcome measure was 30-day rebleeding, while weighted mean averages at t = three, seven, 14 and 28 to 30 days are also reported.
resultsOf 756 citations, six RCTs were included (561 patients; 58.5% to 89.5% male; 55.3 to 67.5 years of age). Among patients receiving high-dose PPI (five RCTs [393 patients]), 11.5% (95% CI 8.4% to 14.7%) experienced rebleeding, 55.6% (95% CI 41.1% to 70.1%) rebled within three days, 20% (95% CI 8.3% to 31.7%) between four and seven days, 17.8% (95% CI 6.6% to 28.9%) at eight to 14 days, and 6.7% (95% CI 0% to 14%) at 15 to 28 to 30 days. Using the relaxed lower PPI dosing threshold, similar respective rates were 14.4% (95% CI 11.5% to 17.3%) overall, with interval rates of 39.5% (95% CI 28.9% to 50.15%), 34.6% (95% CI 24.2% to 44.9%), 19.7% (95% CI 11% to 28.4%) and 6.2% (95% CI 0.95% to 11.5%). Qualitative review of patient characteristics, limited by small sample size, possible bias and study heterogeneity, suggested increased patient comorbidity and postendoscopic use of lower PPI dosing may predict delayed rebleeding.
conclusionIn patients with high-risk PUR undergoing successful endoscopic hemostasis, most rebled within three days, with many experiencing later rebleeding. Additional research is needed to better predict such an outcome.
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