IS ADMINISTRATION OF INTRAVENOUS PROTON PUMP INHIBITOR TO ALL PATIENTS PRESENTING WITH UPPER GI BLEEDING COST EFFECTIVE?
KP Rioux, A Levy, Y Gagnon, R Enns Division of Gastroenterology, Departments of Medicine and Health Care Epidemiology, St Paul s Hospital, University of British Columbia, Vancouver, British Columbia Recent trials (Lau et al. NEJM 2000;343:310-6) have provided solid proof that administration of proton pump inhibitors (PPI) intravenously (bolus then continuous infusion) after endoscopic therapy of peptic ulcer disease (PUD) significantly reduces the incidence of rebleeding, surgery and duration of hospitalization. OBJECTIVE: By using this most recent data, to develop a cost-effectiveness model to determine if administration of IV PPI to all patients presenting with acute UGI bleeding is cost effective. METHODS: We compared the current practice (endoscopic treatment within 48 hours followed by selective use of PPIs) with a strategy of treating all patients with UGI bleeding with IV PPIs. Our model accounted for the costs of IV PPI, endoscopic procedures, surgery and days in hospital. We p
