Long-term recurrent bleeding rate of bleeding peptic ulcer

The bleeding from peptic ulcer is a common and serious complication with the mortality being reported from 5%-10%. Endoscopic therapy has been effective in controlling active bleeding and reducing the emergency surgery, immediate mortality rate and the incidence of early rebleeding. However, there has been only a few reports on the long-term recurrent bleeding rate in patients with bleeding peptic ulcer. The aim of this study was to determine the long-term recurrent bleeding rate and the factors predisposing to recurrent bleeding. Eighty-eight patients with bleeding peptic ulcer discharged after the medical treatment in our hospital between Dec. 1990 and Jul. 1992 were included and the medical records were reviwed, followed by the telephone interviewing. The follow-up was ended at the time of recurrent bleeding, surgery due to the complications or death. Among 88 patients, the retrospective follow-up was available in 76 patients. The recurrent bleeding occurred in 22 patients (29%) during the median follow-up period of 69 months (range, 1-79). The estimated cumulative recurrent bleeding rate after 1, 2, 3, 4, 5 and 6 years was 11.8, 14.5, 19.9, 24.2, 27.2 and 34.2%, respectively. There was no difference between the recurrent bleeding group and non-recurrent bleeding group in age, sex, prior NSAIDs use, previous history of bleeding or peptic ulcer, site of ulcer, stigmata of recent hemorrhage at initial gastroscopic examination, method of treatment and amount of transfusion. Recurrent bleeding occurred after 6 years in one-third of patients with bleeding peptic ulcer, while one-third of patients with recurrent bleeding rebled within 1 year. The factors predisposing to rebleeding during the long-term follow-up were not identified in this study. In order to identify the factors predisposing to recurrent bleeding, further studies are needed including Helicobacter pylori status.