Systematic review and meta-analysis: proton-pump inhibitor treatment for ulcer bleeding reduces transfusion requirements and hospital stay – results from the Cochrane Collaboration
Article first published online: 21 JUL 2005
Alimentary Pharmacology & Therapeutics
Volume 22, Issue 3, pages 169–174, August 2005
How to Cite
LEONTIADIS, G. I., SHARMA, V. K. and HOWDEN, C. W. (2005), Systematic review and meta-analysis: proton-pump inhibitor treatment for ulcer bleeding reduces transfusion requirements and hospital stay – results from the Cochrane Collaboration. Alimentary Pharmacology & Therapeutics, 22: 169–174. doi: 10.1111/j.1365-2036.2005.02546.x
- Issue published online: 21 JUL 2005
- Article first published online: 21 JUL 2005
- Accepted for publication 11 May 2005
Background: Proton-pump inhibitors reduce re-bleeding and surgical intervention, but not mortality, after ulcer bleeding.
Aim: To examine the effects of proton-pump inhibitor treatment on transfusion requirements and length of hospital stay in patients with ulcer bleeding.
Methods: For the Cochrane Collaboration meta-analysis of randomized-controlled trials of proton-pump inhibitor therapy for ulcer bleeding, outcomes of transfusion requirements and hospital stay were summarized, respectively, as mean (±s.d.) units transfused and hospital days. We calculated weighted mean difference with 95% confidence interval. We also performed subgroup analyses according to geographical origin of the randomized-controlled trials.
Results: There was significant heterogeneity among randomized-controlled trials for either outcome. Overall, proton-pump inhibitor treatment marginally reduced transfusion requirements (WMD = −0.6 units; 95% CI: −1.1 to 0; P = 0.05) and length of hospitalization (WMD = −1.1 days; 95% CI: −1.5 to −0.7; P < 0.0001). Most of the randomized-controlled trials did not state precise criteria for administering blood transfusion and discharging patients, thereby limiting the strength of conclusions on the pooled effects.
Conclusions: Proton-pump inhibitor treatment for ulcer bleeding produces small, but potentially important, reductions in transfusion requirements and length of hospitalization.