Somatostatin adjunctive therapy for non-variceal upper gastrointestinal rebleeding after endoscopic therapy

Table 1 Clinical characteristics of treatment groups (mean ± SD) n (%)

	Pantoprazole group(n = 52)	Somatostatin group(n = 49)	Total cohort(n = 101)	P value
Sex (male)	19 (36.5)	13 (26.5)	32 (31.7)	0.280
Age (yr)	65.44 ± 19.46	64.24 ± 14.13	64.86 ± 17.01	0.735
Hemodynamic shock	26 (50.0)	27 (55.1)	53 (52.5)	0.608
Helicobacter pylori infection	14 (26.9)	8 (16.3)	22 (21.8)	0.197
Hemoglobin (g/dL)	8.56 ± 2.84	8.26 ± 2.61	8.41 ± 2.72	0.857
Hemoglobin < 7 g/dL	17 (32.7)	16 (32.7)	33 (32.7)	0.997
Blood urea nitrogen (mg/dL)	40.20 ± 27.06	39.47 ± 26.83	39.84 ± 26.82	0.920
Creatinine (mg/dL)	1.17 ± 0.80	1.29 ± 1.33	1.23 ± 1.09	0.187
Albumin (g/dL)	3.12 ± 0.54	2.79 ± 0.59	2.96 ± 0.59	0.173
Type 2 diabetes mellitus	12 (23.1)	16 (32.7)	28 (27.7)	0.283
Hypertension	22 (43.3)	19 (38.8)	41 (40.6)	0.718
Heart failure	7 (13.5)	4 (8.2)	11 (10.9)	0.393
Ischemic heart disease	15 (28.8)	11 (22.4)	26 (25.7)	0.462
Antiplatelet medication	24 (46.2)	20 (40.8)	44 (43.6)	0.589
NSAID	6 (11.5)	3 (6.1)	9 (8.9)	0.340
Multiple antiplatelet medications	5 (9.6)	2 (4.1)	7 (6.9)	0.274
Steroids	2 (3.8)	4 (8.2)	6 (5.9)	0.359
Melena	31 (59.6)	28 (57.1)	59 (58.4)	0.801
Hematemesis	28 (53.8)	32 (65.3)	60 (59.4)	0.241
Hematochezia	2 (3.8)	5 (10.2)	7 (6.9)	0.209
Complete Rockall score	6.84 ± 1.47	6.87 ± 1.31	6.86 ± 1.39	0.911
Rockall score > 6	26 (50.0)	29 (59.2)	55 (54.5)	0.354
Early rebleeding	6 (12.2)	7 (14.3)	13 (13.3)	0.766

NSAID: Non-steroidal anti-inflammatory drug.

Table 2 Endoscopic findings between treatment groups n (%)

	Pantoprazole group(n = 52)	Somatostatin group(n = 49)	Total cohort(n = 101)	P value
Cause of bleeding				0.177
Gastric ulcer	27 (51.9)	29 (59.2)	56 (55.4)
Duodenal ulcer	11 (21.2)	8 (16.3)	19 (18.8)
Dieulafoy lesion	13 (25.0)	7 (14.3)	20 (19.8)
Mallory–Weiss syndrome	1 (1.9)	5 (10.2)	6 (5.9)
Forrest type				0.894
Ia	3 (5.8)	4 (8.2)	7 (6.9)
Ib	24 (46.2)	22 (44.9)	46 (45.5)
IIa	25 (48.1)	23 (46.9)	48 (47.5)
Loss of stigma	49 (94.2)	47 (95.9)	96 (95.0)	0.696

Table 3 Rebleeding according to endoscopic findings n (%)

	No rebleeding(n = 88)	Rebleeding(n = 13)	Total(n = 101)	P value
Forrest type				0.990
Ia	6 (6.8)	1 (7.7)	7 (6.9)
Ib	40 (45.5)	6 (46.2)	46 (45.5)
IIa	42 (47.7)	6 (46.2)	48 (47.5)
Loss of stigma	84 (95.5)	12 (92.3)	96 (95.0)	0.625

Table 4 Clinical characteristics according to occurrence of early rebleeding event (mean ± SD) n (%)

	No rebleeding(n = 88)	Rebleeding(n = 13)	Total(n = 101)	P value
Sex (male)	27 (30.7)	5 (38.5)	32 (31.7)	0.574
Age (yr)	64.25 ± 17.40	69.0 ± 13.97	64.86 ± 17.01	0.350
Hemodynamic shock	46 (52.3)	7 (53.8)	53 (52.5)	0.916
Helicobacter infection	19 (21.6)	3 (23.1)	22 (21.8)	0.904
Hemoglobin (g/dL)	8.61 ± 2.77	7.09 ± 2.02	8.41 ± 2.72	0.060
Hemoglobin < 7 g/dL	26 (29.5)	7 (53.8)	33 (32.7)	0.081
Blood urea nitrogen (mg/dL)	39.81 ± 25.92	40.09 ± 33.50	39.84 ± 26.82	0.972
Creatinine (mg/dL)	1.26 ± 1.12	1.03 ± 0.83	1.23 ± 1.09	0.473
Albumin (g/dL)	2.97 ± 0.60	2.86 ± 0.47	2.96 ± 0.59	0.532
Type 2 diabetes mellitus	21 (23.9)	3 (23.1)	24 (23.8)	0.950
Hypertension	38 (43.2)	3 (23.1)	41 (40.6)	0.168
Heart failure	9 (10.2)	2 (15.4)	11 (10.9)	0.577
Ischemic heart disease	17 (19.3)	1 (7.7)	18 (17.8)	0.454
Antiplatelet medication	37 (42.0)	7 (53.8)	44 (43.6)	0.423
NSAID	7 (8.0)	2 (15.4)	9 (8.9)	0.380
Multiple antiplatelet medications	5 (5.7)	2 (15.4)	7 (6.9)	0.221
Steroid	5 (5.7)	1 (7.7)	6 (5.9)	0.572
Melena	50 (56.8)	9 (69.2)	59 (58.4)	0.397
Hematemesis	51 (58.0)	4 (30.8)	55 (54.5)	0.066
Hematochezia	5 (5.7)	2 (15.4)	7 (6.9)	0.199
Complete Rockall score	6.73 ± 1.40	7.69 ± 1.03	6.86 ± 1.39	0.020
Rockall score > 6	43 (48.9)	12 (92.3)	55 (54.5)	0.003
Somatostatin use	41 (46.6)	8 (61.5)	49 (48.5)	0.314

NSAID: Non-steroidal anti-inflammatory drug.

Table 5 Predictors of early rebleeding on multivariate analysis

	P value	Exp (B)	95% CI
Adjunct somatostatin use	0.374	0.527	0.128-2.164
Hypertension	0.175	2.864	0.627-13.086
Multiple antiplatelet medication	0.421	2.351	0.239-18.879
Hemoglobin < 7 g/dL	0.402	1.768	0.466-6.704
Hematemesis	0.072	3.672	0.889-15.179
Hematochezia	0.614	0.593	0.078-4.517
Complete Rockall score > 6	0.044	9.080	1.062-77.595