Comparison of surgical and medical management of bleeding peptic ulcers
During 1975-80, 908 patients admitted to Nottingham hospitals with gastrointestinal bleeding and found to have gastric or duodenal ulcers were analysed retrospectively for short-term outcome of treatment. Overall one-quarter of all patients underwent operation, but when the years 1975-7 were compare...
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| Veröffentlicht in: | BMJ 1982-02, Vol.284 (6315), p.548-550 |
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| creator | Vellacott, K D Dronfield, M W Atkinson, M Langman, M J |
| description | During 1975-80, 908 patients admitted to Nottingham hospitals with gastrointestinal bleeding and found to have gastric or duodenal ulcers were analysed retrospectively for short-term outcome of treatment. Overall one-quarter of all patients underwent operation, but when the years 1975-7 were compared with 1978-80 the operation rate fell from one in three to just over one in five. Death rates were much lower in patients treated medically than in those who underwent operation, and the risks of operation were greater for patients with gastric ulcer. Less conventional operations were attended by greater mortality. Almost all patients who died during medical treatment and three-quarters of those who died after operation were over 65. No differences in age or clear variations in haemoglobin concentrations or transfusion requirements were found between the earlier and later periods. Reduction in operation rates had no appreciable effect on mortality, despite the accepted view that early operation is advisable. |
| doi_str_mv | 10.1136/bmj.284.6315.548 |
| format | Article |
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Overall one-quarter of all patients underwent operation, but when the years 1975-7 were compared with 1978-80 the operation rate fell from one in three to just over one in five. Death rates were much lower in patients treated medically than in those who underwent operation, and the risks of operation were greater for patients with gastric ulcer. Less conventional operations were attended by greater mortality. Almost all patients who died during medical treatment and three-quarters of those who died after operation were over 65. No differences in age or clear variations in haemoglobin concentrations or transfusion requirements were found between the earlier and later periods. 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Overall one-quarter of all patients underwent operation, but when the years 1975-7 were compared with 1978-80 the operation rate fell from one in three to just over one in five. Death rates were much lower in patients treated medically than in those who underwent operation, and the risks of operation were greater for patients with gastric ulcer. Less conventional operations were attended by greater mortality. Almost all patients who died during medical treatment and three-quarters of those who died after operation were over 65. No differences in age or clear variations in haemoglobin concentrations or transfusion requirements were found between the earlier and later periods. Reduction in operation rates had no appreciable effect on mortality, despite the accepted view that early operation is advisable.</description><subject>Adult</subject><subject>Aged</subject><subject>Bleeding</subject><subject>Blood Transfusion</subject><subject>Duodenal ulcer</subject><subject>Duodenal Ulcer - complications</subject><subject>Female</subject><subject>Health outcomes</subject><subject>Hospital admissions</subject><subject>Humans</subject><subject>Male</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Peptic ulcer</subject><subject>Peptic Ulcer Hemorrhage - drug therapy</subject><subject>Peptic Ulcer Hemorrhage - mortality</subject><subject>Peptic Ulcer Hemorrhage - surgery</subject><subject>Physicians</subject><subject>Postoperative Complications</subject><subject>Stomach ulcer</subject><subject>Stomach Ulcer - complications</subject><issn>0267-0623</issn><issn>0959-8138</issn><issn>1468-5833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1982</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkd2L1DAUxYMo67Duuy9CQfBFOt40n30RZNBVGFzWT_Dlkjbp2LFtatKK-9-bOsPo-mJebsj55XLuPYQ8pLCmlMlnVb9fF5qvJaNiLbi-Q1aUS50LzdhdsoJCqhxkwe6Tixj3AFAwpUvJz8iZ1ACCqRW53Ph-NKGNfsh8k8U57NradJkZbNY7-_vem8HsXO-GaUGqzqX3YZeNbpzaOpu72oX4gNxrTBfdxbGek4-vXn7YvM63V5dvNi-2eSWomHJti0ZpS21VuoZWGmoqmDBUFjKVIh3mqAVlbe1sKQU3yXVZUdCMlsw07Jw8P_Qd5yr5q5OpYDocQ9ubcIPetHhbGdqvuPM_kPJSUsZTgyfHBsF_n12csG9j7brODM7PERUHYExBAh__A-79HIY0HFKlZFpl2nui4EDVwccYXHOyQgGXlDClhCklXFLClFL68ujvEU4fjpn80fdx8uEkF6UAwWHR84Pexsn9POkmfEOpmBL49tMGxZftZ379DvB94p8e-MXJf939Av52s50</recordid><startdate>19820220</startdate><enddate>19820220</enddate><creator>Vellacott, K D</creator><creator>Dronfield, M W</creator><creator>Atkinson, M</creator><creator>Langman, M J</creator><general>British Medical Journal Publishing Group</general><general>British Medical Association</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19820220</creationdate><title>Comparison of surgical and medical management of bleeding peptic ulcers</title><author>Vellacott, K D ; 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| fulltext | fulltext |
| identifier | ISSN: 0267-0623 |
| ispartof | BMJ, 1982-02, Vol.284 (6315), p.548-550 |
| issn | 0267-0623 0959-8138 1468-5833 |
| language | eng |
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| source | MEDLINE; Jstor Complete Legacy; PubMed Central |
| subjects | Adult Aged Bleeding Blood Transfusion Duodenal ulcer Duodenal Ulcer - complications Female Health outcomes Hospital admissions Humans Male Medical treatment Middle Aged Mortality Peptic ulcer Peptic Ulcer Hemorrhage - drug therapy Peptic Ulcer Hemorrhage - mortality Peptic Ulcer Hemorrhage - surgery Physicians Postoperative Complications Stomach ulcer Stomach Ulcer - complications |
| title | Comparison of surgical and medical management of bleeding peptic ulcers |
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