Epinephrine injection therapy versus a combination of epinephrine injection and endoscopic hemoclip in the treatment of bleeding ulcers

Table 1 Clinical characteristics of patients in the two treatment groups.

	Epinephrine injection alone (n = 202)	Combination therapy (n = 91)	P value
Gender (male:female)	152:50:00	59:32:00	0.066
Age (yr)	61±17	66±16	0.016
(range in years)	(21–89)	(24–90)
Smoking, n (%)	61 (30.2)	30 (33.0)	0.674
Alcohol, n (%)	42 (20.8)	12 (13.2)	0.108
Recent NSAID usage, n (%)	70 (34.7)	37 (40.7)	0.338
Past history of peptic ulcer, n (%)	64 (31.7)	25 (27.5)	0.453
Past history of UGIB, n (%)	35 (17.3)	15 (16.5)	0.845
Lowest Hb	9.1±2.5	8.7±2.5	0.162
(range in g/dL)	(4.1-16.4)	(4.3-17.9)
Ulcer type (GU:DU)	76:126	40:51:00	0.305
Endoscopic major SRH, n (%)
-active bleeding	82 (40.6)	46 (50.5)
-visible vessel	102 (50.5)	42 (46.2)	0.185
-adherent clot	18 (8.9)	3 (3.3)
ASA physical status, n (% )
-P1 (Healthy; no medical problems)	78 (38.6)	25 (27.5)
-P2 (Mild systemic disease)	51 (25.2)	23 (25.3)	0.124
-P3 (Severe systemic disease)	73 (36.1)	43 (47.3)

Table 2 Frequency of comorbid conditions of patients in the two treatment groups.

	Epinephrine injection alone (n = 202), n (%)	Combination therapy (n = 91), n (%)	P value
Ischemic heart disease	50 (24.8)	28 (30.8)	0.281
Hypertension	69 (34.2)	40 (44.0)	0.108
Diabetes mellitus	44 (21.8)	25 (27.5)	0.288
Stroke	19 (9.4)	12 (13.2)	0.330
Chronic renal failure	9 (4.5)	10 (11.0)	0.036
Liver cirrhosis	9 (4.5)	1 (1.1)	0.143
Osteoarthritis	20 (6.8)	8 (2.7)	0.755
Malignancy	7 (3.5)	4 (4.4)	0.698
At least 1 comorbid illness	124 (61.4)	66 (72.5)	0.065

Table 3 Clinical outcome measures of the patients in the two treatment groups.

	Epinephrine injection (n = 202), n (%)	Combination therapy (n = 91), n (%)	P value1
Initial hemostasis	199 (98.5)	91 (100)	0.637
Rebleeding	8 (4.0)	10 (11.0)	0.108
Emergency surgery	3 (1.5)	1 (1.1)	0.412
30-d mortality	11 (5.4)	6 (6.6)	0.754

¹P value calculated using multivariate analysis to account for the increased age and increased frequency of chronic renal failure in the group receiving combination therapy.