Donnellan, C.F.; Clements, D.G.; Watt, A.L.; Healey, C.J.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA114
Academic Journal
Introduction: Airedale Hospital is a DGH serving a population of 200 000 in North and West Yorkshire. Publication of RCT data has recently demonstrated significant benefits of a 72 hour IV omeprazole infusion, for patients with peptic ulcers who undergo endoscopic haemostasis. This therapy was therefore incorporated into clinical practice in November 2001. Aims and Methods: To assess the effectiveness of IV omeprazole on outcomes, a retrospective audit of all patients receiving this therapy was undertaken. This group was compared to all those who had previously received endoscopic therapy alone in the same unit. Patients were identified by their endoscopy reports, held on computer database. Case notes were then examined to assess age, Rockall score, time to endoscopy, transfusion requirements, rebleeding, surgery rate, and 30 day mortality. Groups were compared using the Mann-Whitney U and Chi-squared tests as appropriate. Results: There was 100% case note retrieval. Over 11 months, 26 patients (14 DUs, 12 GUs) received IV omeprazole after endoscopic therapy for peptic ulcers. 27 controls (16 DUs, 11 GUs) were identified over the previous 2 years. Mean age (65.3 vs 64.9) Rockall score (5.2 vs 5.3) and time to endoscopy (79.3% vs 81.5% within 24 hours) were not significantly different between the 2 groups. The rebleed rate (19.2% vs 29.6%), surgery rate (11.5% vs 25.9%) and 30 day mortality (3.8% vs 11.1%) were all improved in the group receiving IV omeprazole, but did not reach statistical significance. Blood transfusion requirements were significantly lower (3.1 vs 6.6 units, p < 0.005). Conclusions: Patients receiving IV omeprozole had lower rates of rebleeding, surgical intervention and mortality, as well as lower transfusion requirements. Only the number of units transfused reached statistical significance, but all other outcome measures improved in the IV omeprazole group. Historical controls were used and there was no difference in age or risk...


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