PPIs for upper GI Bleeds?

31 Mar

some NNT recap (check the links below)

NO BENEFIT (prior to endoscopy):

  • no difference in
    • death,
    • needing surgery,
    • preventing repeat bleeding

 

  • there was a 14% reduction in endoscopic hemostasis in the PPI group (NNT=7)

But the clinically important outcomes for upper GIB, PPI’s don’t seem to do much.

 

ON THE OTHER HAND:

  • in Asian population studies, there did seem to be some benefit, but not in European/Western populations
    • No difference in:
      • death,
      • blood transfusions
      • shorter hospital stay

 

    • 6.6% were helped by preventing rebleeding
    • 3.2% were helped by avoiding a surgical intervention
    • 10% were helped by avoiding repeat endoscopy

 

Interesting food for thought.

 
References: NNT endoscopy; NNT asian population; picture

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