Table 3.
Summary results of subgroup analyses in patients with ulcer bleeding
|
Pooled rates (%)
|
|||||
|---|---|---|---|---|---|
| Subgroup analyses and outcomes | PPI | Control | Heterogeneity (P value) | Odds ratio (95% CI) | Number needed to treat (95% CI) |
| H2 receptor antagonist as control (14 trials) | |||||
| Mortality | 4.2 | 4.2 | No (0.89) | 1.02 (0.51 to 2.05) | Not calculable |
| Rebleeding | 10.4 | 17.6 | No (0.51) | 0.53 (0.35 to 0.78) | 13 (8 to 25) |
| Surgical intervention | 7.9 | 11.1 | No (0.36) | 0.68 (0.38 to 1.20) | 25 (13 to 100) |
| Placebo as control (7 trials) | |||||
| Mortality | 5.7 | 4.9 | Yes (0.02) | 0.96 (0.43 to 2.15) | Not calculable |
| Rebleeding | 10.7 | 19.2 | Yes (0.005) | 0.41 (0.23 to 0.72) | 11 (8 to 20) |
| Surgical intervention | 8.7 | 13.5 | Yes (0.09) | 0.52 (0.32 to 0.84) | 20 (13 to 50) |
|
IV PPI versus IV placebo or IV H2 receptor antagonist (16 trials)
|
|
|
|
||
| Mortality | 6.0 | 5.0 | No (0.15) | 1.22 (0.84 to 1.78) | Not calculable |
| Rebleeding | 10.9 | 17.1 | No (0.15) | 0.57 (0.44 to 0.73) | 17 (11 to 25) |
| Surgical intervention | 9.0 | 12.6 | No (0.55) | 0.67 (0.50 to 0.90) | 25 (17 to 100) |
|
“High dose” IV PPI versus IV placebo or IV H2 receptor antagonist (4 trials)
|
|
|
|
||
| Mortality | 5.7 | 5.6 | Yes (0.02) | 0.98 (0.25 to 3.77) | Not calculable |
| Rebleeding | 5.2 | 12.8 | Yes (0.09) | 0.39 (0.18 to 0.87) | 11 (5 to 50) |
| Surgical intervention | 5.2 | 9.4 | No (0.36) | 0.53 (0.31 to 0.89) | 25 (14 to 100) |
|
IV PPI in doses other than “high dose” versus IV placebo or IV H2 receptor antagonist (12 trials)
|
|
|
|||
| Mortality | 6.3 | 4.5 | No (0.76) | 1.42 (0.85 to 2.38) | Not calculable |
| Rebleeding | 16.1 | 20.3 | No (0.53) | 0.67 (0.50 to 0.91) | 17 (10 to 100) |
| Surgical intervention | 12.3 | 15.3 | No (0.60) | 0.76 (0.53 to 1.08) | Not calculable |
|
Oral PPI treatment versus oral placebo or H2 receptor antagonist (5 trials)
|
|
|
|
||
| Mortality | 2.5 | 3.6 | No (0.64) | 0.67 (0.28 to 1.64) | Not calculable |
| Rebleeding | 9.5 | 24.0 | No (0.20) | 0.32 (0.20 to 0.50) | 7 (5 to 11) |
| Surgical intervention | 6.5 | 14.4 | No (0.47) | 0.38 (0.22 to 0.66) | 13 (8 to 25) |
|
Routine EHT before randomisation (13 trials)
|
|
|
|
|
|
| Mortality | 4.1 | 4.1 | No (0.24) | 1.01 (0.64 to 1.61) | Not calculable |
| Rebleeding | 8.6 | 15.0 | No (0.11) | 0.52 (0.39 to 0.70) | 14 (11 to 25) |
| Surgical intervention | 5.4 | 9.3 | No (0.73) | 0.53 (0.35 to 0.79) | 25 (14 to 50) |
|
No routine EHT before randomisation (8 trials)
|
|
|
|
|
|
| Mortality | 7.0 | 5.6 | No (0.34) | 1.25 (0.75 to 2.09) | Not calculable |
| Rebleeding | 16.0 | 25.8 | Yes (0.03) | 0.38 (0.18 to 0.81) | 9 (5 to 50) |
| Surgical intervention | 12.8 | 18.6 | No (0.16) | 0.64 (0.46 to 0.89) | 17 (10 to 50) |
|
Routine EHT before randomisation and use of high dose IV PPI treatment (4 trials)
|
|
|
|||
| Mortality | 5.7 | 5.6 | Yes (0.02) | 0.98 (0.25 to 3.77) | Not calculable |
| Rebleeding | 5.2 | 12.8 | Yes (0.09) | 0.39 (0.18 to 0.87) | 11 (8 to 33) |
| Surgical intervention | 5.2 | 9.4 | No (0.36) | 0.53 (0.31 to 0.89) | 25 (17 to 100) |
|
Routine EHT before randomisation and use of lower dose IV or oral PPI treatment (9 trials)
|
|
|
|||
| Mortality | 2.4 | 2.4 | No (0.80) | 1.00 (0.42 to 2.35) | Not calculable |
| Rebleeding | 10.2 | 17.2 | No (0.42) | 0.52 (0.35 to 0.78) | 14 (8 to 33) |
| Surgical intervention | 6.6 | 9.9 | No (0.71) | 0.59 (0.33 to 1.05) | Not calculable |
|
Endoscopic findings of active bleeding or NBVV before randomisation (10 trials)
|
|
|
|
||
| Mortality | 2.8 | 5.5 | No (0.79) | 0.51 (0.26 to 1.01) | Not calculable |
| Rebleeding | 10.5 | 24.7 | No (0.23) | 0.33 (0.22 to 0.50) | 7 (5 to 13) |
| Surgical intervention | 5.6 | 12.2 | No (0.69) | 0.39 (0.23 to 0.65) | 14 (10 to 33) |
|
Active bleeding or NBVV; routine EHT before randomisation (5 trials)
|
|
|
|
||
| Mortality | 2.7 | 5.2 | No (0.59) | 0.51 (0.23 to 1.12) | Not calculable |
| Rebleeding | 11.6 | 25.7 | Yes (0.09) | 0.35 (0.17 to 0.72) | 8 (6 to 17) |
| Surgical intervention | 4.5 | 7.3 | No (0.56) | 0.54 (0.27 to 1.08) | Not calculable |
|
Active bleeding or NBVV; without routine EHT before randomisation (5 trials)
|
|
|
|
||
| Mortality | 3.5 | 6.5 | No (0.57) | 0.51 (0.12 to 2.12) | Not calculable |
| Rebleeding | 19.4 | 46.8 | No (1.00) | 0.29 (0.13 to 0.63) | 4 (2 to 10) |
| Surgical intervention | 8.7 | 24.6 | No (0.81) | 0.27 (0.12 to 0.57) | 6 (4 to 14) |
PPI=proton pump inhibitor, IV=intravenous, EHT=endoscopic haemostatic therapy, NBVV=non-bleeding visible vessel.