Pre-endoscopic PP1 therapy reduces recurrent adverse outcomes in acute non-variceal upper gastrointestinal bleeding: authors' reply

摘要

Sirs, Thank you for the insightful comments regarding our manuscript. We would like to address some of the concerns raised by Dr Lin. First, he comments that there is a much higher incidence of high-risk stigmata in the group who received pre-endoscopic proton pump inhibitor (PPI) therapy. We think he may have misinterpreted the table, as the numbers given are not absolute numbers, but instead are proportions {i.e. not 44/132 but 44% out of a total number of 132). Also, as patients may have had multiple lesions and multiple stigmata (i.e. both a non-bleeding visible vessel and oozing from another site) the proportions are not purely additive. In our study, there was a trend towards a decrease in the risk of having high-risk stigmata with pre-endoscopic PPI therapy (47?o vs. 57?o, F ?0.085), with high-risk stigmata defined as active arterial bleeding, non-bleeding visible vessel, adherent clot or oozing. This finding suggests that pre-endoscopic PPI therapy may assist in stabilizing clots and improving ulcer healing, leading to increased down-grading of high-risk stigmata.