Management of Peptic Ulcer Bleeding in Different Case Volume Workplaces: Results of a Nationwide Inquiry in Hungary

The aim of this study was to conduct a national survey to evaluate the recent endoscopic treatment and drug therapy of peptic ulcer bleeding (PUB) patients and to compare practices in high and low case volume Hungarian workplaces. A total of 62 gastroenterology units participated in the six-month st...

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Main Authors: István Rácz, Tibor Kárász, Krisztina Lukács, Ferenc Rácz, János Kersák, Judit Wacha, Tibor Szalóki, Magdolna Szász, István Gyenes, István Altorjay
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2012/956434
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author István Rácz
Tibor Kárász
Krisztina Lukács
Ferenc Rácz
János Kersák
Judit Wacha
Tibor Szalóki
Magdolna Szász
István Gyenes
István Altorjay
author_facet István Rácz
Tibor Kárász
Krisztina Lukács
Ferenc Rácz
János Kersák
Judit Wacha
Tibor Szalóki
Magdolna Szász
István Gyenes
István Altorjay
author_sort István Rácz
collection DOAJ
description The aim of this study was to conduct a national survey to evaluate the recent endoscopic treatment and drug therapy of peptic ulcer bleeding (PUB) patients and to compare practices in high and low case volume Hungarian workplaces. A total of 62 gastroenterology units participated in the six-month study. A total of 3033 PUB cases and a mean of 8.15±3.9 PUB cases per month per unit were reported. In the 23 high case volume units (HCV), there was a mean of 12.9±5.4 PUB cases/month, whereas in the 39 low case volume units (LCV), a mean of 5.3±2.9 PUB cases/month were treated during the study period. In HCV units, endoscopic therapies for Forrest Ia, Ib, and IIa ulcers were significantly more often used than in LCV units (86% versus 68%; P=0.001). Among patients with stigmata of recent haemorrhage (Forrest I, II), bolus + continuous infusion PPI was given significantly more frequently in HCV than in LCV units (49.6% versus 33.2%; P=0.001). Mortality in HCV units was less than in LCV units (2.7% versus 4.3%; P=0.023). The penetration of evidence-based recommendations for PUB management is stronger in HCV units resulting lower mortality.
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institution Kabale University
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publishDate 2012-01-01
publisher Wiley
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series Gastroenterology Research and Practice
spelling doaj-art-1d05134428cb433ca589da9684340a7f2025-08-20T03:54:51ZengWileyGastroenterology Research and Practice1687-61211687-630X2012-01-01201210.1155/2012/956434956434Management of Peptic Ulcer Bleeding in Different Case Volume Workplaces: Results of a Nationwide Inquiry in HungaryIstván Rácz0Tibor Kárász1Krisztina Lukács2Ferenc Rácz3János Kersák4Judit Wacha5Tibor Szalóki6Magdolna Szász7István Gyenes8István Altorjay9Division of Gastroenterology, Department of Internal Medicine, Petz Aladár County and Teaching Hospital, Győr 9024, HungaryDivision of Gastroenterology, Department of Internal Medicine, Petz Aladár County and Teaching Hospital, Győr 9024, HungaryDepartment of Gastroenterology, School of Medicine, Debrecen University, Debrecen 4032, HungaryDepartment of Internal Medicine, Jósa András County Hospital, Nyíregyháza 4400, HungaryDepartment of Internal Medicine, Municipal Hospital, Siófok 8600, HungaryDepartment of Surgery, Semmelweis University, Budapest 1083, HungaryDepartment of Internal Medicine, Jávorszky Ödön Municipal Hospital, Vác 2600, HungaryDepartment of Internal Medicine, Jávorszky Ödön Municipal Hospital, Vác 2600, HungaryDepartment of Internal Medicine, Kenézy Gyula County Hospital, Debrecen 4031, HungaryDepartment of Gastroenterology, School of Medicine, Debrecen University, Debrecen 4032, HungaryThe aim of this study was to conduct a national survey to evaluate the recent endoscopic treatment and drug therapy of peptic ulcer bleeding (PUB) patients and to compare practices in high and low case volume Hungarian workplaces. A total of 62 gastroenterology units participated in the six-month study. A total of 3033 PUB cases and a mean of 8.15±3.9 PUB cases per month per unit were reported. In the 23 high case volume units (HCV), there was a mean of 12.9±5.4 PUB cases/month, whereas in the 39 low case volume units (LCV), a mean of 5.3±2.9 PUB cases/month were treated during the study period. In HCV units, endoscopic therapies for Forrest Ia, Ib, and IIa ulcers were significantly more often used than in LCV units (86% versus 68%; P=0.001). Among patients with stigmata of recent haemorrhage (Forrest I, II), bolus + continuous infusion PPI was given significantly more frequently in HCV than in LCV units (49.6% versus 33.2%; P=0.001). Mortality in HCV units was less than in LCV units (2.7% versus 4.3%; P=0.023). The penetration of evidence-based recommendations for PUB management is stronger in HCV units resulting lower mortality.http://dx.doi.org/10.1155/2012/956434
spellingShingle István Rácz
Tibor Kárász
Krisztina Lukács
Ferenc Rácz
János Kersák
Judit Wacha
Tibor Szalóki
Magdolna Szász
István Gyenes
István Altorjay
Management of Peptic Ulcer Bleeding in Different Case Volume Workplaces: Results of a Nationwide Inquiry in Hungary
Gastroenterology Research and Practice
title Management of Peptic Ulcer Bleeding in Different Case Volume Workplaces: Results of a Nationwide Inquiry in Hungary
title_full Management of Peptic Ulcer Bleeding in Different Case Volume Workplaces: Results of a Nationwide Inquiry in Hungary
title_fullStr Management of Peptic Ulcer Bleeding in Different Case Volume Workplaces: Results of a Nationwide Inquiry in Hungary
title_full_unstemmed Management of Peptic Ulcer Bleeding in Different Case Volume Workplaces: Results of a Nationwide Inquiry in Hungary
title_short Management of Peptic Ulcer Bleeding in Different Case Volume Workplaces: Results of a Nationwide Inquiry in Hungary
title_sort management of peptic ulcer bleeding in different case volume workplaces results of a nationwide inquiry in hungary
url http://dx.doi.org/10.1155/2012/956434
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