Endoclips vs large or small-volume epinephrine in peptic ulcer recurrent bleeding

Table 1 Clinical and endoscopic characteristics of the patients at study entry n (%)

	Group 1(n = 50)	Group 2 (n = 50)	Group 3 (n = 50)
Age (yr)	68 (40-96)	61 (30-92)	67 (40-94)
Gender (M/F)	31/19	33/17	34/16
Location of ulcer
Stomach	26 (52)	23 (46)	28 (56)
Duodenum	24 (48)	27 (54)	22 (44)
Ulcer size (cm)
< 2	36 (72)	44 (88 )	37 (74)
≥ 2	14 (28)	6 (12)	13 (26)
Gastric content
Blood	19 (38)	22 (44)	21 (42)
Coffee ground	31 (62)	28 (56)	29 (58)
Shock	4 (8)	2 (4)	1 (2)
Hb level (g/dL)	9.3 (3.9-14.7)	9.0 (3.6-14.2)	9.4 (5.6-14.3)
Comorbid disease	36 (72)	35 (70)	33 (60)
NSAIDs	15 (30)	23 (46)	29 (58)
Alcohol consumption	20 (40)	23 (46)	30 (60)
Smoker’s	12 (24)	16 (32)	10 (20)
Previous ulcer disease	14 (28)	10 (20)	11 (22)
Previous ulcer bleeding	12 (24)	10 (20)	8 (16)

Continuous data are expressed as mean (95% CI). NSAIDs: Non-steroidal anti-inflammatory drugs.

Table 2 Clinical outcomes of endoscopic therapy n (%)

	Group 1	Group 2	Group 3
Primary outcome
Early recurrent bleeding	15 (30)	8 (16)	2 (4)cb
Stigmata
Spurting	4 (26.7)	1 (12.5)	1 (50)
Oozing	5 (33.3)	2 (25)	1 (50)
Visible vessel	6 (40)	5 (62.5)	0
Secondary outcomes
Initial hemostasis	50 (100)	50 (100)	50 (100)
Permanent hemostasis	44 (88)	46 (92)	48 (96)
Emergency surgery	6 (12)	4 (8)	2 (4)
30-d mortality	3 (6)	0 (0)	4 (8)
Blood transfusion (mL)	1041 (120-1997)	912 (0-2039)	840 (0-1893)
Hospital stays (d)	7.5 (1-14)	7.6 (1-15)	5.7(1-15)bd

Continuous data are expressed as mean (95% CI).

^bP < 0.01 vs group 1;

^cP < 0.05,

^dP < 0.01 vs group 2. Pearson χ² test.

Table 3 Therapeutic efficacy of small-volume and large-volume epinephrine, and hemoclips in reducing recurrent bleeding (95% CI)

Recurrent bleeding rate (%)	RRR (%)	ARR (%)	NNT
Small-volume vs large-volume epinephrine	46.6 (-11.2-75.0)	14.0 (-2.6-30.3)	8.0 (37.7-3.3)
Small-volume epinephrine vs hemoclips	86.7 (51.7-96.5)	26.0 (12.3-40.4)	4.0 (2.5-8.1)
Large-volume epinephrine vs hemoclips	75.0 (9.0-23.0)	12.0 (0.2-25.0)	9.0 (4.0-476.0)

RRR: Relative risk reduction; ARR: Absolute risk reduction; NNT: Number needs to treat.