Consensus on control of risky nonvariceal upper gastrointestinal bleeding in Taiwan with National Health Insurance

Bor Shyang Sheu, Chun Ying Wu, Ming Shiang Wu, Cheng Tang Chiu, Chun Che Lin, Ping I. Hsu, Hsiu Chi Cheng, Teng Yu Lee, Hsiu Po Wang, Jaw Town Lin

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background and Aims. To compose upper gastrointestinal bleeding (UGIB) consensus from a nationwide scale to improve the control of UGIB, especially for the high-risk comorbidity group. Methods. The steering committee defined the consensus scope to cover preendoscopy, endoscopy, postendoscopy, and overview from Taiwan National Health Insurance Research Database (NHIRD) assessments for UGIB. The expert group comprised thirty-two Taiwan experts of UGIB to conduct the consensus conference by a modified Delphi process through two separate iterations to modify the draft statements and to vote anonymously to reach consensus with an agreement ≥80% for each statement and to set the recommendation grade. Results. The consensus included 17 statements to highlight that patients with comorbidities, including liver cirrhosis, end-stage renal disease, probable chronic obstructive pulmonary disease, and diabetes, are at high risk of peptic ulcer bleeding and rebleeding. Special considerations are recommended for such risky patients, including raising hematocrit to 30% in uremia or acute myocardial infarction, aggressive acid secretory control in high Rockall scores, monitoring delayed rebleeding in uremia or cirrhosis, considering cycloxygenase-2 inhibitors plus PPI for pain control, and early resumption of antiplatelets plus PPI in coronary artery disease or stroke. Conclusions. The consensus comprises recommendations to improve care of UGIB, especially for high-risk comorbidities.

Original languageEnglish
Article number563707
JournalBioMed research international
Volume2014
DOIs
Publication statusPublished - 2014

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

Fingerprint Dive into the research topics of 'Consensus on control of risky nonvariceal upper gastrointestinal bleeding in Taiwan with National Health Insurance'. Together they form a unique fingerprint.

  • Cite this