Clinical characteristics of 281 cases of peptic ulcer bleeding
Objective:To summarize the clinical characteristics of 281 cases of peptic ulcer bleeding in Hainan, in order to provide a theoretical basis for further prevention and treatment of peptic ulcer bleeding in this region.Methods:A total of 281 patients with an endoscopic diagnosis of bleeding peptic ulcer who visited the Second Affiliated Hospital of Hainan Medical College for hematemesis and melena from December 2020 to December 2022 were selected. Patients with peptic ulcer bleeding were classified into a low-risk group (IIc and III) and a high-risk group (Ⅰa-Ⅱb) according to the endoscopic Forrest classification. Patients in the high-risk group were further subdivided into a non-rebleeding subgroup and a rebleeding subgroup according to whether rebleeding occurred after endoscopic hemostasis. General information and clinical characteristics of the patients were collected and analyzed, and factors influencing high-risk ulcers were analyzed by multivariate logistic regression.Results:In 281 patients with bleeding peptic ulcer, the male to female ratio was 4.73∶1; the Helicobacter pylori (Hp) infection rate was 63.7%; 189 cases (67.3%) lived in rural areas; 163 cases (58.0%) were in the elderly group and 118 (42.0%) in the non-elderly group; 148 cases (52.7%) were in the high-risk group and 133 (47.3%) in the low-risk group; 30 cases (10.7%) were in the rebleeding subgroup and 251 (89.3%) in the non-rebleeding subgroup; and the rebleeding rate was 18.9% in the high-risk ulcer patients. Patients in the high-risk group were significantly more likely to be men and have smoking history, history of home-brewed liquor consumption, Hp infection, ulcer diameter >2 cm, and rebleeding than those of the low-risk group, and had higher prothrombin time (PT) and urea nitrogen levels than the low-risk group (P<0.05). Logistic regression analysis showed that drinking home-brewed liquor (odds ratio [OR]=3.319, P=0.001), Hp infection (OR=2.455, P=0.001), PT (OR=1.202, P=0.026), and ulcer diameter >2 cm (OR=3.041, P=0.029) were independent risk factors for high-risk peptic ulcer bleeding. There were more ulcers >2 cm in diameter in the rebleeding subgroup than in the non-rebleeding subgroup.Conclusion:Among patients with bleeding peptic ulcers in Hainan, there are more elderly patients than non-elderly patients and more men than women. Drinking home-brewed white wine, Hp infection, PT, and ulcer diameter >2 cm are independent risk factors for high-risk ulcers. Large diameter ulcers may be a major risk factor for rebleeding after endoscopic treatment.
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