Continuous Intravenous Infusion of Omeprazole in Elderly Patients with Peptic Ulcer Bleeding Results of a Placebo-Controlled Multicenter Study

G. Hasselgren Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Östra sjukhuset, Göteborg; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Kärnsjukhuset, Skövde; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Södersjukhuset, Stockholm; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Astra Hässle AB, Mölndal, Sweden; Depts. of Medicine, Aker sykehus, Oslo, and Sentralsykehuset, Fredrikstad, Norway

T. Lind Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Östra sjukhuset, Göteborg; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Kärnsjukhuset, Skövde; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Södersjukhuset, Stockholm; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Astra Hässle AB, Mölndal, Sweden; Depts. of Medicine, Aker sykehus, Oslo, and Sentralsykehuset, Fredrikstad, Norway

L. Lundell Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Östra sjukhuset, Göteborg; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Kärnsjukhuset, Skövde; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Södersjukhuset, Stockholm; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Astra Hässle AB, Mölndal, Sweden; Depts. of Medicine, Aker sykehus, Oslo, and Sentralsykehuset, Fredrikstad, Norway

E. Aadland Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Östra sjukhuset, Göteborg; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Kärnsjukhuset, Skövde; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Södersjukhuset, Stockholm; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Astra Hässle AB, Mölndal, Sweden; Depts. of Medicine, Aker sykehus, Oslo, and Sentralsykehuset, Fredrikstad, Norway

P. Efskind Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Östra sjukhuset, Göteborg; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Kärnsjukhuset, Skövde; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Södersjukhuset, Stockholm; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Astra Hässle AB, Mölndal, Sweden; Depts. of Medicine, Aker sykehus, Oslo, and Sentralsykehuset, Fredrikstad, Norway

A. Falk Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Östra sjukhuset, Göteborg; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Kärnsjukhuset, Skövde; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Södersjukhuset, Stockholm; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Astra Hässle AB, Mölndal, Sweden; Depts. of Medicine, Aker sykehus, Oslo, and Sentralsykehuset, Fredrikstad, Norway

A. Hyltander Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Östra sjukhuset, Göteborg; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Kärnsjukhuset, Skövde; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Södersjukhuset, Stockholm; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Astra Hässle AB, Mölndal, Sweden; Depts. of Medicine, Aker sykehus, Oslo, and Sentralsykehuset, Fredrikstad, Norway

C. Söderlund Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Östra sjukhuset, Göteborg; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Kärnsjukhuset, Skövde; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Södersjukhuset, Stockholm; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Astra Hässle AB, Mölndal, Sweden; Depts. of Medicine, Aker sykehus, Oslo, and Sentralsykehuset, Fredrikstad, Norway

S. Eriksson Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Östra sjukhuset, Göteborg; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Kärnsjukhuset, Skövde; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Södersjukhuset, Stockholm; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Astra Hässle AB, Mölndal, Sweden; Depts. of Medicine, Aker sykehus, Oslo, and Sentralsykehuset, Fredrikstad, Norway

P. Fernström Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Östra sjukhuset, Göteborg; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Kärnsjukhuset, Skövde; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Södersjukhuset, Stockholm; Depts. of Surgery, Sahlgrenska University Hospital, Dept. of Surgery, Astra Hässle AB, Mölndal, Sweden; Depts. of Medicine, Aker sykehus, Oslo, and Sentralsykehuset, Fredrikstad, Norway

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Abstract

Background: Does profound acid inhibition by continuous infusion of omeprazole for 72 h reduce further bleeding in elderly patients with peptic ulcer bleeding (PUB)? Methods: Three hundred and thirty-three patients ≥60 years old with PUB were randomized to omeprazole (80 mg + 8 mg/h) or placebo as continuous infusion for 72 h. From day 4 to 21 all patients received 20 mg omeprazole orally once daily. Results: When evaluated on day 3, the primary variable ‘overall outcome’ (based on an ordinal ranking scale; see Study variables) (P = 0.017) and the secondary variables, surgery (P = 0.003), degree (P = 0.004) and duration of bleeding (P = 0.003) all favored the omeprazole group. Blood transfusions, need for endoscopic treatment, and mortality were not statistically different. On follow-up, by day 21, the mortality in the group initially receiving intravenous omeprazole was 6.9%, while the intravenous placebo group showed an extremely low mortality, 0.6%. Conclusion: Three days' infusion of omeprazole improved overall outcome and reduced need for intervention in PUB patients.

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Continuous Intravenous Infusion of Omeprazole in Elderly Patients with Peptic Ulcer Bleeding Results of a Placebo-Controlled Multicenter Study

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Continuous Intravenous Infusion of Omeprazole in Elderly Patients with Peptic Ulcer Bleeding Results of a Placebo-Controlled Multicenter Study

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