Systematic review and meta-analysis

Proton-pump inhibitor treatment for ulcer bleeding reduces transfusion requirements and hospital stay - Results from the Cochrane Collaboration

G. I. Leontiadis, V. K. Sharma, Colin Howden

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Background: Proton-pump inhibitors reduce re-bleeding and surgical intervention, but not mortality, after ulcer bleeding. Aim: To examine the effects of proton-pump inhibitor treatment on transfusion requirements and length of hospital stay in patients with ulcer bleeding. Methods: For the Cochrane Collaboration meta-analysis of randomized-controlled trials of proton-pump inhibitor therapy for ulcer bleeding, outcomes of transfusion requirements and hospital stay were summarized, respectively, as mean (±s.d.) units transfused and hospital days. We calculated weighted mean difference with 95% confidence interval. We also performed subgroup analyses according to geographical origin of the randomized-controlled trials. Results: There was significant heterogeneity among randomized-controlled trials for either outcome. Overall, proton-pump inhibitor treatment marginally reduced transfusion requirements (WMD = -0.6 units; 95% CI: -1.1 to 0; P = 0.05) and length of hospitalization (WMD = -1.1 days; 95% CI: -1.5 to -0.7; P < 0.0001). Most of the randomized-controlled trials did not state precise criteria for administering blood transfusion and discharging patients, thereby limiting the strength of conclusions on the pooled effects. Conclusions: Proton-pump inhibitor treatment for ulcer bleeding produces small, but potentially important, reductions in transfusion requirements and length of hospitalization.

Original languageEnglish (US)
Pages (from-to)169-174
Number of pages6
JournalAlimentary Pharmacology and Therapeutics
Volume22
Issue number3
DOIs
StatePublished - Aug 1 2005
Externally publishedYes

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Proton Pump Inhibitors
Ulcer
Meta-Analysis
Length of Stay
Hemorrhage
Randomized Controlled Trials
Hospitalization
Therapeutics
Hospital Units
Blood Transfusion
Confidence Intervals
Mortality

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)

Cite this

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title = "Systematic review and meta-analysis: Proton-pump inhibitor treatment for ulcer bleeding reduces transfusion requirements and hospital stay - Results from the Cochrane Collaboration",
abstract = "Background: Proton-pump inhibitors reduce re-bleeding and surgical intervention, but not mortality, after ulcer bleeding. Aim: To examine the effects of proton-pump inhibitor treatment on transfusion requirements and length of hospital stay in patients with ulcer bleeding. Methods: For the Cochrane Collaboration meta-analysis of randomized-controlled trials of proton-pump inhibitor therapy for ulcer bleeding, outcomes of transfusion requirements and hospital stay were summarized, respectively, as mean (±s.d.) units transfused and hospital days. We calculated weighted mean difference with 95{\%} confidence interval. We also performed subgroup analyses according to geographical origin of the randomized-controlled trials. Results: There was significant heterogeneity among randomized-controlled trials for either outcome. Overall, proton-pump inhibitor treatment marginally reduced transfusion requirements (WMD = -0.6 units; 95{\%} CI: -1.1 to 0; P = 0.05) and length of hospitalization (WMD = -1.1 days; 95{\%} CI: -1.5 to -0.7; P < 0.0001). Most of the randomized-controlled trials did not state precise criteria for administering blood transfusion and discharging patients, thereby limiting the strength of conclusions on the pooled effects. Conclusions: Proton-pump inhibitor treatment for ulcer bleeding produces small, but potentially important, reductions in transfusion requirements and length of hospitalization.",
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AU - Howden, Colin

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N2 - Background: Proton-pump inhibitors reduce re-bleeding and surgical intervention, but not mortality, after ulcer bleeding. Aim: To examine the effects of proton-pump inhibitor treatment on transfusion requirements and length of hospital stay in patients with ulcer bleeding. Methods: For the Cochrane Collaboration meta-analysis of randomized-controlled trials of proton-pump inhibitor therapy for ulcer bleeding, outcomes of transfusion requirements and hospital stay were summarized, respectively, as mean (±s.d.) units transfused and hospital days. We calculated weighted mean difference with 95% confidence interval. We also performed subgroup analyses according to geographical origin of the randomized-controlled trials. Results: There was significant heterogeneity among randomized-controlled trials for either outcome. Overall, proton-pump inhibitor treatment marginally reduced transfusion requirements (WMD = -0.6 units; 95% CI: -1.1 to 0; P = 0.05) and length of hospitalization (WMD = -1.1 days; 95% CI: -1.5 to -0.7; P < 0.0001). Most of the randomized-controlled trials did not state precise criteria for administering blood transfusion and discharging patients, thereby limiting the strength of conclusions on the pooled effects. Conclusions: Proton-pump inhibitor treatment for ulcer bleeding produces small, but potentially important, reductions in transfusion requirements and length of hospitalization.

AB - Background: Proton-pump inhibitors reduce re-bleeding and surgical intervention, but not mortality, after ulcer bleeding. Aim: To examine the effects of proton-pump inhibitor treatment on transfusion requirements and length of hospital stay in patients with ulcer bleeding. Methods: For the Cochrane Collaboration meta-analysis of randomized-controlled trials of proton-pump inhibitor therapy for ulcer bleeding, outcomes of transfusion requirements and hospital stay were summarized, respectively, as mean (±s.d.) units transfused and hospital days. We calculated weighted mean difference with 95% confidence interval. We also performed subgroup analyses according to geographical origin of the randomized-controlled trials. Results: There was significant heterogeneity among randomized-controlled trials for either outcome. Overall, proton-pump inhibitor treatment marginally reduced transfusion requirements (WMD = -0.6 units; 95% CI: -1.1 to 0; P = 0.05) and length of hospitalization (WMD = -1.1 days; 95% CI: -1.5 to -0.7; P < 0.0001). Most of the randomized-controlled trials did not state precise criteria for administering blood transfusion and discharging patients, thereby limiting the strength of conclusions on the pooled effects. Conclusions: Proton-pump inhibitor treatment for ulcer bleeding produces small, but potentially important, reductions in transfusion requirements and length of hospitalization.

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