0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

Risk of Postoperative Upper Gastrointestinal Tract Hemorrhage in Patients With Active Peptic Ulcer Disease Undergoing Nonulcer Surgery

Ralph K. Della Ratta, MD; Mark J. Corapi, MD; Bruce R. Horowitz, MD; Anthony J. Calio, MD
Arch Intern Med. 1993;153(18):2141-2144. doi:10.1001/archinte.1993.00410180095011.
Text Size: A A A
Published online

Background:  Although peptic ulcer disease (PUD) is common in adults, the risk of bleeding from an active ulcer after nonulcer surgery is poorly defined in the literature. The objectives of this study were to define the risk of postoperative upper gastrointestinal (UGI) tract hemorrhage in patients with active PUD and to identify risk factors that predict bleeding.

Methods:  This case-control study was conducted at a suburban community teaching hospital. Sixty patients with active PUD at the time of nonulcer surgery were identified and compared with a control group of 120 patients without PUD. All charts were reviewed for the presence of coagulopathy, antiplatelet and anticoagulant drug use, preoperative and postoperative UGI tract bleeding, and perioperative medical therapy for PUD.

Results:  Cases and controls were similar in age, length of stay, number of procedures, type of surgery, anticoagulant use, and presence of coagulopathy. Most patients had general surgery; none had neurosurgery, and few had cardiac surgery. Patients with PUD had a greater number of major diagnoses (P<.02), rate of preoperative UGI tract bleeding (P<.001), and use of perioperative antiulcer medications (P<.02). There was no difference in the rate of postoperative UGI tract bleeding between the two groups (P=.63; odds ratio, 1.3; 95% confidence interval, 1.21 to 1.41). There were no patient characteristics that predicted postoperative UGI tract bleeding. While 10% of patients with PUD experienced postoperative UGI tract bleeding, only one required blood transfusion; in the majority, the bleeding was clinically unimportant.

Conclusion:  For patients with PUD similar to this study group, nonulcer surgery need not be deferred to allow for peptic ulcer healing.(Arch Intern Med. 1993;153:2141-2144)

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 1

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();