Digestive Diseases and Sciences

, Volume 63, Issue 11, pp 3033–3040 | Cite as

The Use of Higher Dose Steroids Increases the Risk of Rebleeding After Endoscopic Hemostasis for Peptic Ulcer Bleeding

  • Yutaka Kondo
  • Waku HattaEmail author
  • Tomoyuki Koike
  • Yasushi Takahashi
  • Masahiro Saito
  • Takeshi Kanno
  • Kiyotaka Asanuma
  • Naoki Asano
  • Akira Imatani
  • Atsushi Masamune
Original Article



Previous studies have shown that several factors such as hemodynamic instability at admission are risk factors for rebleeding of peptic ulcer bleeding. However, whether steroid use increases the risk of rebleeding remains elusive.


This study aimed to clarify the risk factors for rebleeding after endoscopic hemostasis for peptic ulcer bleeding.


A total of 185 patients who underwent endoscopic hemostasis for peptic ulcer bleeding at our institution between 2005 and 2017 were retrospectively analyzed. We evaluated factors, including comorbid conditions, in-hospital onset, and steroid use, associated with rebleeding by logistic regression analysis. In addition, we investigated the association between the dose of steroids and rebleeding.


The rebleeding rate after endoscopic hemostasis for peptic ulcer bleeding was 14.6%. In the multivariate analysis, the independent risk factors for rebleeding were steroid use (odds ratio 4.56, p = 0.015), multiple ulcers (4.43, p = 0.005), number of comorbidities ≥ 3 3.18, p = 0.026), hemodynamic instability (3.06, p = 0.039), and number of comorbidities ≥ 3 (2.93, p = 0.047). Furthermore, the use of higher dose steroids (≥ 20 mg per day in prednisolone; 10.55, p = 0.002), but not lower dose (< 20 mg per day in prednisolone), was an independent risk factor for rebleeding in the multivariate analysis. The relationship between steroid use and rebleeding was observed in a dose-dependent manner (p for trend = 0.002).


This study first revealed that using higher dose steroids was an independent risk factor for rebleeding after endoscopic hemostasis for peptic ulcer bleeding, with a dose-response relation.


Steroid Rebleeding Peptic ulcer bleeding Dose-dependent relation 



Peptic ulcer bleeding


Nonsteroid antiinflammatory drugs




Proton pump inhibitor


American Society of Anesthesiologists




Interquartile range


Odds ratios


Percutaneous endoscopic gastrostomy


Endoscopic naso-biliary drainage


Confidence interval


Compliance with ethical standards

Conflict of interest

All authors have no conflicts to declare.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Yutaka Kondo
    • 1
  • Waku Hatta
    • 1
    Email author
  • Tomoyuki Koike
    • 1
  • Yasushi Takahashi
    • 1
  • Masahiro Saito
    • 1
  • Takeshi Kanno
    • 1
  • Kiyotaka Asanuma
    • 1
  • Naoki Asano
    • 1
  • Akira Imatani
    • 1
  • Atsushi Masamune
    • 1
  1. 1.Division of GastroenterologyTohoku University Graduate School of MedicineSendaiJapan

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