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

研究成果: Article

8 引文 (Scopus)

摘要

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.

原文English
文章編號563707
期刊BioMed research international
2014
DOIs
出版狀態Published - 2014

指紋

Health insurance
National Health Programs
Taiwan
Consensus
Hemorrhage
Comorbidity
Pulmonary diseases
Endoscopy
Uremia
Medical problems
Liver
Acids
Monitoring
Peptic Ulcer
Hematocrit
Liver Cirrhosis
Chronic Obstructive Pulmonary Disease
Chronic Kidney Failure
Coronary Artery Disease
Fibrosis

All Science Journal Classification (ASJC) codes

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

引用此文

Sheu, Bor Shyang ; Wu, Chun Ying ; Wu, Ming Shiang ; Chiu, Cheng Tang ; Lin, Chun Che ; Hsu, Ping I. ; Cheng, Hsiu Chi ; Lee, Teng Yu ; Wang, Hsiu Po ; Lin, Jaw Town. / Consensus on control of risky nonvariceal upper gastrointestinal bleeding in Taiwan with National Health Insurance. 於: BioMed research international. 2014 ; 卷 2014.
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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.",
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Consensus on control of risky nonvariceal upper gastrointestinal bleeding in Taiwan with National Health Insurance. / Sheu, Bor Shyang; Wu, Chun Ying; Wu, Ming Shiang; Chiu, Cheng Tang; Lin, Chun Che; Hsu, Ping I.; Cheng, Hsiu Chi; Lee, Teng Yu; Wang, Hsiu Po; Lin, Jaw Town.

於: BioMed research international, 卷 2014, 563707, 2014.

研究成果: Article

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AU - Wu, Chun Ying

AU - Wu, Ming Shiang

AU - Chiu, Cheng Tang

AU - Lin, Chun Che

AU - Hsu, Ping I.

AU - Cheng, Hsiu Chi

AU - Lee, Teng Yu

AU - Wang, Hsiu Po

AU - Lin, Jaw Town

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