Evidence map›Paper›PMID 31222633›Full record

Observational studySurgical endoscopy2020

The recurrent bleeding risk of a Forrest IIc lesion at the second-look endoscopy can be indicated by high Rockall scores ≥ 6.

Er-Hsiang Yang, Chung-Tai Wu, Hsin-Yu Kuo, Wei-Ying Chen, Bor-Shyang Sheu, Hsiu-Chi Cheng

3 registry-linked trialsOpen access · bronzeAbstract readObservational Study
In one paragraph

Observational study in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact, top 88% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01591083 phase4completednot on this map

The Studies of the Pathophysiologic Mechanisms of Poor Ulcer Healing & Clinical Improvement to the High Ulcer Rebleeding Rate for Patients With Comorbid Illnesses

TypeinterventionalSponsorNational Cheng-Kung University HospitalRan2011 to 2014Enrolled474ConditionsPeptic Ulcer BleedingArmsesomeprazole (Nexium®, AstraZeneca AB, Södertälje, Sweden)
NCT05248321 nacompletednot on this mapstarted 2022, after this paper: background citation

Precise Application of Topical Tranexamic Acid to Enhance Endoscopic Hemostasis for Peptic Ulcer Bleeding: A Randomized Controlled Study

TypeinterventionalSponsorNational Cheng-Kung University HospitalRan2022 to 2023Enrolled60ConditionsPeptic Ulcer HemorrhageArmsTranexamic Acid Powder
NCT07772700 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Potassium-competitive Acid Blocker Versus Double Dose Proton Pump Inhibitors in High High-risk Peptic Ulcer Bleeding: A Randomized Controlled Trial

TypeinterventionalSponsorNational Cheng-Kung University HospitalRan2026 to 2027Enrolled108ConditionsBleedingArmsVonoprazon, Esomeprazole
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Er-Hsiang YangDepartment of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Chung-Tai WuDepartment of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Hsin-Yu KuoDepartment of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Wei-Ying ChenDepartment of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Bor-Shyang SheuDepartment of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. sheubs@mail.ncku.edu.tw.ORCID http://orcid.org/0000-0002-1500-6929
Hsiu-Chi ChengDepartment of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. teishuki@mail.ncku.edu.tw.ORCID http://orcid.org/0000-0003-0954-0647
National Cheng Kung University Hospital · TWChest Hospital, Ministry of Health and Welfare · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Forrest classification is widely applied to guide endoscopic hemostasis for peptic ulcer bleeding. Accordingly, practice guidelines suggest medical treatment only for ulcer with a Forrest IIc lesion because it has low rebleeding risk even without endoscopic therapy, ranging from 0 to 13%. However, the risk ranges widely and it is unclear who is at risk of rebleeding with such a lesion. This study assessed whether the Rockall score, which evaluates patients holistically, could indicate the risk of recurrent bleeding among patients with a Forrest IIc lesion at the second-look endoscopy.

methodsPatients who had peptic ulcer bleeding with Ia-IIb lesions received endoscopic hemostasis at the primary endoscopy, and they were enrolled if their Ia-IIb lesions had been fading to IIc at the second-look endoscopy after 48- to 72-h intravenous proton pump inhibitor (PPI) infusion. Primary outcomes were rebleeding during the 4th-14th day and 4

resultsThe prospective cohort study enrolled 140 patients, who were divided into a Rockall scores ≥ 6 group or a Rockall scores < 6 group. The rebleeding rates in the Rockall scores ≥ 6 group and the Rockall scores < 6 group during the 4th-14th day and the 4th-28th day were 13/70 (18.6%) versus 2/70 (2.9%), p = 0.003 and 17/70 (24.3%) versus 3/70 (4.3%), p = 0.001, respectively, based on an intention-to-treat analysis and 5/62 (8.1%) versus 0/68 (0%), p = 0.023 and 6/59 (10.2%) versus 0/67 (0%), p = 0.009, respectively, based on a per-protocol analysis. The Kaplan-Meier curves showed that the Rockall scores ≥ 6 group had a significantly lower cumulative rebleeding-free proportion than the Rockall scores < 6 group (p = 0.01).

conclusionsCombined Rockall scores ≥ 6 on arrival with a Forrest IIc lesion at the second-look endoscopy can identify patients at risk of recurrent peptic ulcer bleeding following initial endoscopic and intravenous PPI treatment. Trial registration Trial registration identifier: NCT01591083.

Indexed as

AgedAged, 80 and overFemaleGastroscopyHemostasis, EndoscopicHumansInfusions, IntravenousKaplan-Meier EstimateMaleMiddle AgedPeptic Ulcer HemorrhageProspective StudiesProton Pump InhibitorsRecurrenceSecond-Look SurgeryStomach UlcerProton Pump InhibitorsForrest classificationPeptic ulcer bleedingRecurrent bleedingRockall scoreSecond-look endoscopy

Identifiers

PMID31222633
PMCPMC7223755
OpenAlexW2950316979

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.