Original Research
Tuesday, October 15, 2024
08:30 AM–10:00 AM
Abstract
Introduction: Upper gastrointestinal (GI) bleeding is a significant cause of morbidity and mortality. Proton pump inhibitors (PPIs) are a standard treatment, but the addition of octreotide, a somatostatin analog, may offer additional benefits. This study aims to compare the clinical efficacy and safety of PPI alone versus PPI combined with octreotide in managing upper GI bleeding.
Research Question or Hypothesis: Does the combination of proton pump inhibitors (PPIs) and octreotide improve clinical outcomes and safety compared to PPI monotherapy in patients with non-variceal upper gastrointestinal bleeding?
Study Design: This is single-center retrospective cohort study
Methods: Data were collected on demographics and clinical characteristics. Clinical presentations included bleeding signs, time to endoscopy, bleeding location, and therapy duration. Outcomes measured were discharge status, adverse events, need for transfusion, ICU stay duration, APACHE score, and lab results.
Results: A total of 174 patients with non-variceal upper GI bleeding were included: 152 treated with PPI alone and 22 treated with both PPI and octreotide. Ethnicity distribution was significantly different (p=0.017), with a higher proportion of Middle Eastern patients in the PPI group. ICU admission was more common in the PPI+octreotide group (13.6% vs. 8.5%, p<0.001). Mechanical ventilation was more frequent in the PPI+octreotide group (54.5% vs. 29.4%, p=0.035). Clinical outcomes: Discharged patients alive with readmission within 30 days was significantly higher in the PPI plus octreotide group (18.2%) compared to the PPI alone group (5.9%), (p=0.021), regarding blood transfusion requirment, no patients in PPI+octreiotide group while 21.6% in PPI need transfusion. Higher mortality in PPI + octreotide group (63.6% vs. 37.9%).
Conclusion: Combining PPI with octreotide may reduce the need for transfusions in non-variceal upper GI bleeding. The higher mortality in the combination group warrants cautious interpretation due to possible confounding factors such as ICU admission and liver disease. Further prospective studies are needed to validate these findings and optimize treatment protocols.
Presenting Author
Abdulhamid Althagafi Pharm.D.king Abdulaziz University
Authors
Rima Alharbi PharmD
King Abdulaziz University
Taif Almrwani PharmD
King Abdulaziz University
Rafal Alsubhi PharmD
King Abdulaziz University
Ghaidaa Bawaked PharmD
King Abdulaziz University