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EVALUATION OF RELATED FACTORS AND SHORT-TERM TREATMENT FAILURE USING HIGH-DOSE INTRAVENOUS NEXIUM IN PATIENTS WITH FORREST IIB CLASSIFIED GASTRIC-DUODENAL ULCER BLEEDING
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Abstract
Background: Many factors influencing the effectiveness of Nexium in patients with upper gastrointestinal hemorrhage due to gastric and duodenal ulcers classified as Forrest IIB have not been fully studied. The severity of the hemorrhage, including the volume of blood loss, unstable vital signs, and the requirement for multiple blood transfusions, are important factors that may affect treatment outcomes. Objectives: Evaluating factors related to treatment failure outcomes of high-dose intravenous Nexium in patients with upper gastrointestinal hemorrhage due to gastric and duodenal ulcers classified as Forrest IIB. Materials and methods: An uncontrolled interventional study was conducted on 51 patients diagnosed with upper gastrointestinal hemorrhage due to gastric and duodenal ulcers classified as Forrest IIB, treated with high-dose intravenous Nexium at Can Tho Central General Hospital from June 2022 to May 2024. Results: The average age of the study subjects was 64,7 ± 17,1 years, with a male-to-female ratio of 2:1. The mean Blatchford score was 11,6 ± 3,0 points. The average transfusion rate was 94,1%, with a median blood transfusion volume of 3 units. The treatment failure rate was recorded at 17,6%. Multivariate logistic regression analysis showed that the number of blood transfusions ≥ 5 units increased the likelihood of treatment failure by 49,3 times (95% CI: 1,8 – 1390,1; p = 0,022) and a heart rate ≥ 100 beats per minute at the time of admission increased it by 20,7 times (95% CI: 1,1 – 409,3; p = 0,046), both statistically significant. Conclusion: Most patients with Forrest IIB gastric-duodenal ulcer bleeding respond well to medical treatment with high-dose intravenous Nexium. Among these patients, the number of blood transfusions ≥ 5 units and a pulse rate ≥ 100 beats per minute at the time of admission were associated with an increased rate of treatment failure.
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Keywords
Gastric and duodenal ulcer bleeding, Forrest classification, FIIB, high-dose intravenous Nexium.
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