A head to head comparison of oral vs intravenous omeprazole for patients with bleeding peptic ulcers with a clean base, flat spots and adherent clots

Table 1 Baseline characteristics of the study groups

Characteristics	Group 1(iv)(n = 112)	Group 2(po)(n = 99)	Total(n = 211)	P
Male / Female (n)	79/33	66/33	145/66	0.545
Age (mean ± SD)	52.7 ± 17.05	52.8 ± 19.61	52.7 ± 18.12	0.9661
Age < 65 yr [n (%)]	80 (71.4)	64 (64.6)	144 (68.2)	0.291
Age ≥ 65 yr [n (%)]	32 (28.6)	35 (35.4)	67 (31.8)
Ulcer site (n):
-Duodenal	94	76	160	0.083
-Gastric	18	23	51
Endoscopic signs (n):
-Clean base	82	62	144	0.244
-Flat spot	20	26	46
-Old adherent clot	10	11	21
Ulcer size (cm)	1.05 ± 0.4	1.06 ± 0.6	1.05 ± 0.5	0.9341
Ulcer count (n):
-Single	106	82	188	0.0072
-Multiple	6	17	23
Ulcer locations (n):
-Posterior duodenal	61	52	113	0.007
-Anterior duodenal	33	14	47
-Gastric corporal	9	16	25
-Gastric antral	9	17	26
Aspirin/NSAIDs use [n (%)]	68 (60.7)	70 (70.7)	138 (65.4)	0.072
H pylori positive [n (%)]	63 (56.3)	56 (56.6)	119 (56.4)	0.963
Previous eradication [n (%)]	10 (8.9)	3 (3.0)	13 (6.2)	0.092
Coexisting illness [n (%)]	41 (36.6)	35 (35.4)	76 (36.1)	0.850
-Cardiac (n)	18	14	32
-Pulmonary (n)	16	15	31
-Cerebral (n)	7	6	13
Previous surgery [n (%)]	19 (17.0)	22 (22.2)	41 (19.4)	0.335
Alcohol [n (%)]	5 (4.5)	2 (2.0)	7 (3.3)	0.4522
Smoking [n (%)]	47 (42.0)	38 (38.4)	85 (40.3)	0.597
Previous pain [n (%)]	72 (64.3)	67 (67.7)	139 (65.9)	0.604
Previous bleeding [n (%)]	17 (15.2)	17 (17.2)	34 (26.1)	0.694
Hematemesis [n (%)]	77 (68.8)	69 (69.7)	146 (69.2)	0.882
Coagulopathy [n (%)]	4 (3.5)	3 (3.0)	7 (3.3)	0.9172
Hematocrit (%, Mean)	24.2 ± 3.2	23.6 ± 3.4	23.9 ± 3.1	0.5671
Index hematocrit < 25% (n) Index hematocrit ≥ 25% (n)	47 65	45 54	92 119	0.610
Shock (n)	6	5	11	0.3812
Rockall score ≤ 3 [n (%)]	63 (56.3)	52 (52.5)	115 (54.5)	0.737
> 8 [n (%)]	21 (18.7)	19 (19.1)	40 (18.9)	0.865

¹Student’s t test;

²Fisher’s exact test; NSAIDs: non-steroidal anti-inflammatory drugs.

Table 2 Clinical outcomes of the study population

Outcome	Group 1(iv)(n = 112)	Group 2(po)(n = 99)	Total(n = 211)	P
Inpatient basis
Recovery [n (%)]	107 (95.5)	95 (96.0)	202 (95.7)	0.945
Re-bleeding [n (%)]	5 (4.5)	4 (4.0)	9 (4.3)	0.8792
Surgery requirement [n (%)]	3 (2.7)	2 (2.0)	5 (2.4)	0.7732
Hospital stay (days, mean) Total ≤ 5 d (n) > 5 d (n)	4.6 ± 1.6 52 60	4.5 ± 2.6 55 44	4.5 ± 2.8 107 104	0.7102 0.093
Blood transfusion (units) Total (mean) ≤ 3 units (n) > 3 units (n)	1.9 ± 1.1 85 27	2.1 ± 1.7 74 25	2.0 ± 1.6 159 52	0.3501 0.847 0.610
Death [n (%)]	2 (1.8)	2 (2.0)	4 (1.9)	0.9812
Outpatient basis
Re-bleeding [n (%)]	2 (1.8)	1 (1.0)	3 (1.4)	0.7662
Death [n (%)]	1 (0.8)	0 (0.0)	1 (0.4)	0.8872
Overall
Re-bleeding [n (%)]	7 (6.2)	5 (5.0)	12 (5.6%)	0.7452
Death [n (%)]	3 (2.6)	2 (2.0)	5 (2.3)	0.9802

¹Student’s t test;

²Fisher’s exact test.

Table 3 Probable effects of variables on re-bleeding

Factor	Re-bleeding (n)	P	OR (95% CI)
Co-existing illness	5	0.288	2.3 (0.6-8.8)
Hematemesis	6	0.971	0.8 (0.2-3.6)
Smoking	5	0.490	1.9 (0.4-7.3)
Aspirin/NSAIDs	7	0.721	1.1 (0.3-8.7)
Age ≥ 65 yr	5	0.117	2.1 (0.7-10.8)
Ulcer size > 1 cm	6	0.001	11 (2.6-46.3)
Ulcer locations:
Posterior duodenal	4	0.041	7 (1.5-18.2)
Gastric corporal	3	0.049	5 (1.0-14.3)
Ulcer stigmata:
Flat spots	5	0.001	12 (4.5-57.3)
Old clots	3	0.023	5 (1.2-13.5)