Table 4:

Clinical outcomes before and after intervention

CharacteristicBefore intervention, % (no. of patients)*After intervention, % (no. of patients)*Between-group comparison, p value
Experimental groupControl groupExperimental groupControl groupUnadjustedAdjusted
High-risk patients who received endoscopic therapy67.8 (152/177)83.3 (155/186)94.7 (143/151)86.1 (124/144)0.090.05
Index endoscopy within 24 h62.8 (252/401)65.6 (278/424)57.5 (207/360)63.1 (245/388)0.30.1
Time to index endoscopy, h, mean ± SD38.0 ± 69.8
n = 401
28.1 ± 40.1
n = 424
33.5 ±51.6
n = 361
28.2 ± 37.2
n = 388
0.80.6
Targeted irrigation of adherent clot performed68.8 (33/48)54.4 (25/46)73.8 (31/42)70.3 (26/37)0.8
Endoscopic treatment performed44.0 (177/402)40.1 (170/424)42.9 (155/361)38.8 (151/389)0.50.9
 Injection37.3 (150/402)31.4 (133/424)36.0 (130/361)29.3 (114/389)0.20.9
  Epinephrine/saline alone30.4 (122/402)30.4 (129/424)28.5 (103/361)27.0 (105/389)0.80.9
  Other7.0 (28/402)0.9 (4/424)7.5 (27/361)2.3 (9/389)0.2
 Thermal18.4 (74/402)21.9 (93/424)19.4 (70/361)17.7 (69/389)0.70.4
 Clips16.9 (68/402)9.7 (41/424)14.4 (52/361)13.6 (53/389)0.80.3
 Other (ligation)0.0 (0/402)0.7 (3/424)1.1 (4/361)0.3 (1/389)0.1
Pre initial endoscopy, total daily dose of PPI, mg, mean ± SD
 Oral66.4 ± 46.4
n = 45
68.3 ± 69.4
n = 48
80.0 ± 46.4
n = 37
68.6 ± 49.5
n = 49
0.40.3
 Intravenous bolus80.0 ± 24.3
n = 277
81.4 ± 25.8
n = 288
81.4 ± 23.1
n = 254
81.5 ± 21.5
n = 288
0.950.9
 Intravenous constant infusion145.0 ± 150.1
n = 273
124.1 ± 129.3
n = 289
124.2 ± 126.6
n = 254
120.1 ± 113.8
n = 288
0.70.7
Post initial endoscopy, total daily dose of PPI, mg, mean ± SD
 Oral91.7 ± 64.1
n = 196
98.8 ± 77.7
n = 246
116.8 ± 74.9
n = 206
116.1 ± 69.0
n = 181
0.950.3
 Intravenous bolus102.1 ± 53.6
n = 76
97.4 ± 68.6
n = 62
104.5 ± 80.8
n = 62
100.4 ± 57.3
n = 51
0.70.7
 Intravenous constant infusion380.4 ± 245.9
n = 285
380.5 ±233.3
n = 306
430.7 ± 258.8
n = 252
402.6 ± 264.5
n = 288
0.30.6
Intensive care unit admission15.7 (63/402)14.9 (63/424)15.5 (56/361)13.1 (51/389)0.60.5
Intensive care unit duration of stay, d, mean ± SD6.0 ± 8.1
n = 63
4.4 ± 5.0
n = 63
4.7 ± 3.7
n = 56
6.5 ± 8.4
n = 51
0.40.4
Re-bleeding, need for surgery or angiography to stop bleeding9.2 (37/402)9.0 (38/424)11.9 (43/361)8.2 (32/389)0.1
Re-bleeding8.0 (32/402)8.0 (34/424)11.1 (40/361)7.2 (28/389)0.1
Need for surgery to stop bleeding2.5 (10/402)1.7 (7/424)1.9 (7/361)2.1 (8/389)0.9
Need for angiographic procedure to stop bleeding2.5 (7/280)2.0 (6/300)2.8 (10/361)2.1 (8/389)0.5
Deaths6.0 (24/402)6.4 (27/424)6.4 (23/361)5.7 (22/389)0.7
Bleeding-related death1.5 (6/402)0.7 (3/424)2.2 (8/361)2.3 (9/389)0.9
Length of stay, d, mean ± SD§10.6 ± 15.4
n = 362
9.6 ± 15.7
n = 381
9.1 ± 10.1
n = 331
9.4 ± 12.1
n = 351
0.80.7
Hospital stay less than 3 d20.0 (77/386)26.7 (109/408)20.1 (71/354)22.3 (83/373)0.70.9
High-risk patients with hospital stay less than 3 d6.9 (12/174)14.6 (27/185)8.5 (13/153)11.8 (17/144)0.40.2
  • Note: PPI = proton pump inhibitors, SD = standard deviation.

  • * Unless otherwise indicated.

  • χ2 for categorical variables or t-tests for continuous variables.

  • Adjusted for baseline, hospital size (≤ 400 v. > 400 beds), Ontario (yes v. no) and interaction of hospital size and Ontario location. Adjustment for site was made for p values using the generalized estimating equations for dichotomous outcomes and mixed models for continuous outcomes.

  • § Time to index endoscopy, ICU length of stay and hospital length of stay were log-transformed to improve normality.

  • Unless patient died during hospital stay.