Scolaris Content Display Scolaris Content Display

Funnel plot of comparison: 1 Main analysis, outcome: 1.1 Mortality ‐ 30 days or at point closest to 30 days.
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Figure 1

Funnel plot of comparison: 1 Main analysis, outcome: 1.1 Mortality ‐ 30 days or at point closest to 30 days.

Funnel plot of comparison: 1 Main analysis, outcome: 1.2 Rebleeding within 30 days.
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Figure 2

Funnel plot of comparison: 1 Main analysis, outcome: 1.2 Rebleeding within 30 days.

Funnel plot of comparison: 1 Main analysis, outcome: 1.3 Surgery for continued or recurrent bleeding within 30 days of randomisation.
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Figure 3

Funnel plot of comparison: 1 Main analysis, outcome: 1.3 Surgery for continued or recurrent bleeding within 30 days of randomisation.

Funnel plot of comparison: 1 Main analysis, outcome: 1.5 Proportion of patients with stigmata of recent haemorrhage.
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Figure 4

Funnel plot of comparison: 1 Main analysis, outcome: 1.5 Proportion of patients with stigmata of recent haemorrhage.

Funnel plot of comparison: 1 Main analysis, outcome: 1.8 Endoscopic haemostatic therapy at index endoscopy.
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Figure 5

Funnel plot of comparison: 1 Main analysis, outcome: 1.8 Endoscopic haemostatic therapy at index endoscopy.

Comparison 1 Main analysis, Outcome 1 Mortality ‐ 30 days or at point closest to 30 days.
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Analysis 1.1

Comparison 1 Main analysis, Outcome 1 Mortality ‐ 30 days or at point closest to 30 days.

Comparison 1 Main analysis, Outcome 2 Rebleeding within 30 days.
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Analysis 1.2

Comparison 1 Main analysis, Outcome 2 Rebleeding within 30 days.

Comparison 1 Main analysis, Outcome 3 Surgery for continued or recurrent bleeding within 30 days of randomisation.
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Analysis 1.3

Comparison 1 Main analysis, Outcome 3 Surgery for continued or recurrent bleeding within 30 days of randomisation.

Comparison 1 Main analysis, Outcome 4 Patients requiring blood transfusion (post hoc analysis).
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Analysis 1.4

Comparison 1 Main analysis, Outcome 4 Patients requiring blood transfusion (post hoc analysis).

Comparison 1 Main analysis, Outcome 5 Proportion of patients with stigmata of recent haemorrhage.
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Analysis 1.5

Comparison 1 Main analysis, Outcome 5 Proportion of patients with stigmata of recent haemorrhage.

Comparison 1 Main analysis, Outcome 6 Proportion of patients with blood in stomach (post hoc analysis).
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Analysis 1.6

Comparison 1 Main analysis, Outcome 6 Proportion of patients with blood in stomach (post hoc analysis).

Comparison 1 Main analysis, Outcome 7 Proportion of patients with active bleeding.
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Analysis 1.7

Comparison 1 Main analysis, Outcome 7 Proportion of patients with active bleeding.

Comparison 1 Main analysis, Outcome 8 Endoscopic haemostatic therapy at index endoscopy.
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Analysis 1.8

Comparison 1 Main analysis, Outcome 8 Endoscopic haemostatic therapy at index endoscopy.

Comparison 2 Analysis according to degree of allocation concealment, Outcome 1 Mortality.
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Analysis 2.1

Comparison 2 Analysis according to degree of allocation concealment, Outcome 1 Mortality.

Comparison 2 Analysis according to degree of allocation concealment, Outcome 2 Rebleeding within 30 days.
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Analysis 2.2

Comparison 2 Analysis according to degree of allocation concealment, Outcome 2 Rebleeding within 30 days.

Comparison 2 Analysis according to degree of allocation concealment, Outcome 3 Surgery for continued or recurrent bleeding within 30 days of randomisation.
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Analysis 2.3

Comparison 2 Analysis according to degree of allocation concealment, Outcome 3 Surgery for continued or recurrent bleeding within 30 days of randomisation.

Comparison 3 Analysis according to control treatment, Outcome 1 Mortality.
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Analysis 3.1

Comparison 3 Analysis according to control treatment, Outcome 1 Mortality.

Comparison 3 Analysis according to control treatment, Outcome 2 Rebleeding within 30 days.
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Analysis 3.2

Comparison 3 Analysis according to control treatment, Outcome 2 Rebleeding within 30 days.

Comparison 3 Analysis according to control treatment, Outcome 3 Surgery for continued or recurrent bleeding within 30 days of randomisation.
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Analysis 3.3

Comparison 3 Analysis according to control treatment, Outcome 3 Surgery for continued or recurrent bleeding within 30 days of randomisation.

Comparison 4 Analysis according to route of PPI administration, Outcome 1 Mortality.
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Analysis 4.1

Comparison 4 Analysis according to route of PPI administration, Outcome 1 Mortality.

Comparison 4 Analysis according to route of PPI administration, Outcome 2 Rebleeding within 30 days.
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Analysis 4.2

Comparison 4 Analysis according to route of PPI administration, Outcome 2 Rebleeding within 30 days.

Comparison 4 Analysis according to route of PPI administration, Outcome 3 Surgery for continued or recurrent bleeding within 30 days of randomisation.
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Analysis 4.3

Comparison 4 Analysis according to route of PPI administration, Outcome 3 Surgery for continued or recurrent bleeding within 30 days of randomisation.

Comparison 5 Analysis according to the PPI used, Outcome 1 Mortality.
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Analysis 5.1

Comparison 5 Analysis according to the PPI used, Outcome 1 Mortality.

Comparison 5 Analysis according to the PPI used, Outcome 2 Rebleeding within 30 days.
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Analysis 5.2

Comparison 5 Analysis according to the PPI used, Outcome 2 Rebleeding within 30 days.

Comparison 5 Analysis according to the PPI used, Outcome 3 Surgery for continued or recurrent bleeding within 30 days of randomisation.
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Analysis 5.3

Comparison 5 Analysis according to the PPI used, Outcome 3 Surgery for continued or recurrent bleeding within 30 days of randomisation.

Comparison 6 Analysis according to report of endoscopic haemostatic treatment, Outcome 1 Mortality.
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Analysis 6.1

Comparison 6 Analysis according to report of endoscopic haemostatic treatment, Outcome 1 Mortality.

Comparison 6 Analysis according to report of endoscopic haemostatic treatment, Outcome 2 Rebleeding.
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Analysis 6.2

Comparison 6 Analysis according to report of endoscopic haemostatic treatment, Outcome 2 Rebleeding.

Comparison 6 Analysis according to report of endoscopic haemostatic treatment, Outcome 3 Surgery.
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Analysis 6.3

Comparison 6 Analysis according to report of endoscopic haemostatic treatment, Outcome 3 Surgery.

Comparison 7 Analysis restricted to peptic ulcer patients, Outcome 1 Mortality.
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Analysis 7.1

Comparison 7 Analysis restricted to peptic ulcer patients, Outcome 1 Mortality.

Comparison 7 Analysis restricted to peptic ulcer patients, Outcome 2 Rebleeding.
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Analysis 7.2

Comparison 7 Analysis restricted to peptic ulcer patients, Outcome 2 Rebleeding.

Comparison 7 Analysis restricted to peptic ulcer patients, Outcome 3 Surgery.
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Analysis 7.3

Comparison 7 Analysis restricted to peptic ulcer patients, Outcome 3 Surgery.

Comparison 1. Main analysis

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality ‐ 30 days or at point closest to 30 days Show forest plot

6

2223

Odds Ratio (M‐H, Fixed, 95% CI)

1.12 [0.75, 1.68]

2 Rebleeding within 30 days Show forest plot

5

2121

Odds Ratio (M‐H, Fixed, 95% CI)

0.81 [0.62, 1.06]

3 Surgery for continued or recurrent bleeding within 30 days of randomisation Show forest plot

5

2165

Odds Ratio (M‐H, Fixed, 95% CI)

0.90 [0.65, 1.25]

4 Patients requiring blood transfusion (post hoc analysis) Show forest plot

4

1512

Odds Ratio (M‐H, Fixed, 95% CI)

0.95 [0.78, 1.16]

5 Proportion of patients with stigmata of recent haemorrhage Show forest plot

4

1332

Odds Ratio (M‐H, Fixed, 95% CI)

0.67 [0.54, 0.84]

6 Proportion of patients with blood in stomach (post hoc analysis) Show forest plot

3

1230

Odds Ratio (M‐H, Random, 95% CI)

0.64 [0.32, 1.30]

7 Proportion of patients with active bleeding Show forest plot

4

1332

Odds Ratio (M‐H, Fixed, 95% CI)

0.74 [0.54, 1.02]

8 Endoscopic haemostatic therapy at index endoscopy Show forest plot

3

1983

Odds Ratio (M‐H, Fixed, 95% CI)

0.68 [0.50, 0.93]

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Comparison 1. Main analysis
Comparison 2. Analysis according to degree of allocation concealment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

6

2223

Odds Ratio (M‐H, Fixed, 95% CI)

1.12 [0.75, 1.68]

1.1 Degree of allocation concealment: A

1

631

Odds Ratio (M‐H, Fixed, 95% CI)

1.16 [0.41, 3.23]

1.2 Degree of allocation concealment: non‐A

5

1592

Odds Ratio (M‐H, Fixed, 95% CI)

1.12 [0.72, 1.73]

2 Rebleeding within 30 days Show forest plot

5

2121

Odds Ratio (M‐H, Fixed, 95% CI)

0.81 [0.62, 1.06]

2.1 Degree of concealment: A

1

631

Odds Ratio (M‐H, Fixed, 95% CI)

1.40 [0.56, 3.53]

2.2 Degree of concealment : non‐A

4

1490

Odds Ratio (M‐H, Fixed, 95% CI)

0.77 [0.58, 1.02]

3 Surgery for continued or recurrent bleeding within 30 days of randomisation Show forest plot

5

2165

Odds Ratio (M‐H, Fixed, 95% CI)

0.90 [0.65, 1.25]

3.1 Degree of concealment: A

1

631

Odds Ratio (M‐H, Fixed, 95% CI)

0.67 [0.19, 2.39]

3.2 Degree of concealment: non‐A

4

1534

Odds Ratio (M‐H, Fixed, 95% CI)

0.92 [0.66, 1.29]

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Comparison 2. Analysis according to degree of allocation concealment
Comparison 3. Analysis according to control treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

6

2223

Odds Ratio (M‐H, Fixed, 95% CI)

1.12 [0.75, 1.68]

1.1 PPI versus placebo

3

1983

Odds Ratio (M‐H, Fixed, 95% CI)

1.19 [0.78, 1.81]

1.2 PPI versus H2RA

2

160

Odds Ratio (M‐H, Fixed, 95% CI)

0.66 [0.18, 2.44]

1.3 PPI versus No Treatment

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Rebleeding within 30 days Show forest plot

5

2121

Odds Ratio (M‐H, Fixed, 95% CI)

0.81 [0.62, 1.06]

2.1 PPI versus placebo

3

1983

Odds Ratio (M‐H, Fixed, 95% CI)

0.87 [0.66, 1.16]

2.2 PPI versus H2RA

1

58

Odds Ratio (M‐H, Fixed, 95% CI)

0.56 [0.14, 2.26]

2.3 PPI versus No Treatment

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

0.39 [0.14, 1.12]

3 Surgery for continued or recurrent bleeding within 30 days of randomisation Show forest plot

5

2165

Odds Ratio (M‐H, Fixed, 95% CI)

0.90 [0.65, 1.25]

3.1 PPI versus placebo

3

1983

Odds Ratio (M‐H, Fixed, 95% CI)

0.90 [0.64, 1.27]

3.2 PPI versus H2RA

1

102

Odds Ratio (M‐H, Fixed, 95% CI)

1.53 [0.45, 5.18]

3.3 PPI versus No Treatment

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

0.37 [0.07, 2.02]

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Comparison 3. Analysis according to control treatment
Comparison 4. Analysis according to route of PPI administration

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

6

Odds Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Oral PPI

1

205

Odds Ratio (M‐H, Fixed, 95% CI)

0.39 [0.07, 2.07]

1.2 Intravenous PPI

5

2018

Odds Ratio (M‐H, Fixed, 95% CI)

1.21 [0.80, 1.84]

2 Rebleeding within 30 days Show forest plot

5

2121

Odds Ratio (M‐H, Fixed, 95% CI)

0.81 [0.62, 1.06]

2.1 Oral PPI

1

205

Odds Ratio (M‐H, Fixed, 95% CI)

1.01 [0.40, 2.54]

2.2 Intravenous PPI

4

1916

Odds Ratio (M‐H, Fixed, 95% CI)

0.79 [0.60, 1.05]

3 Surgery for continued or recurrent bleeding within 30 days of randomisation Show forest plot

5

2165

Odds Ratio (M‐H, Fixed, 95% CI)

0.90 [0.65, 1.25]

3.1 Oral PPI

1

205

Odds Ratio (M‐H, Fixed, 95% CI)

0.49 [0.12, 2.01]

3.2 Intravenous PPI

4

1960

Odds Ratio (M‐H, Fixed, 95% CI)

0.93 [0.67, 1.30]

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Comparison 4. Analysis according to route of PPI administration
Comparison 5. Analysis according to the PPI used

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

6

2223

Odds Ratio (M‐H, Fixed, 95% CI)

1.12 [0.75, 1.68]

1.1 IV Omeprazole

4

1938

Odds Ratio (M‐H, Fixed, 95% CI)

1.21 [0.80, 1.84]

1.2 IV Pantoprazole

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 Oral Lansoprazole

1

205

Odds Ratio (M‐H, Fixed, 95% CI)

0.39 [0.07, 2.07]

2 Rebleeding within 30 days Show forest plot

5

2121

Odds Ratio (M‐H, Fixed, 95% CI)

0.81 [0.62, 1.06]

2.1 IV Omeprazole

3

1836

Odds Ratio (M‐H, Fixed, 95% CI)

0.84 [0.63, 1.13]

2.2 IV Pantoprazole

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

0.39 [0.14, 1.12]

2.3 Oral Lansoprazole

1

205

Odds Ratio (M‐H, Fixed, 95% CI)

1.01 [0.40, 2.54]

3 Surgery for continued or recurrent bleeding within 30 days of randomisation Show forest plot

5

2165

Odds Ratio (M‐H, Fixed, 95% CI)

0.90 [0.65, 1.25]

3.1 IV Omeprazole

3

1880

Odds Ratio (M‐H, Fixed, 95% CI)

0.97 [0.69, 1.37]

3.2 IV Pantoprazole

1

80

Odds Ratio (M‐H, Fixed, 95% CI)

0.37 [0.07, 2.02]

3.3 Oral Lansoprazole

1

205

Odds Ratio (M‐H, Fixed, 95% CI)

0.49 [0.12, 2.01]

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Comparison 5. Analysis according to the PPI used
Comparison 6. Analysis according to report of endoscopic haemostatic treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

6

2223

Odds Ratio (M‐H, Fixed, 95% CI)

1.12 [0.75, 1.68]

1.1 Report of using Endoscopic Haemostatic treatment

3

1983

Odds Ratio (M‐H, Fixed, 95% CI)

1.19 [0.78, 1.81]

1.2 No report of using endoscopic haemostatic treatment

3

240

Odds Ratio (M‐H, Fixed, 95% CI)

0.66 [0.18, 2.44]

2 Rebleeding Show forest plot

5

2121

Odds Ratio (M‐H, Fixed, 95% CI)

0.81 [0.62, 1.06]

2.1 Report of using Endoscopic haemostatic treatment

3

1983

Odds Ratio (M‐H, Fixed, 95% CI)

0.87 [0.66, 1.16]

2.2 No report of using endoscopic haemostatic treatment

2

138

Odds Ratio (M‐H, Fixed, 95% CI)

0.45 [0.20, 1.03]

3 Surgery Show forest plot

5

2165

Odds Ratio (M‐H, Fixed, 95% CI)

0.90 [0.65, 1.25]

3.1 Report of using endoscopic haemostatic treatment

3

1983

Odds Ratio (M‐H, Fixed, 95% CI)

0.90 [0.64, 1.27]

3.2 No report of using endoscopic haemostatic treatment

2

182

Odds Ratio (M‐H, Fixed, 95% CI)

0.91 [0.35, 2.36]

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Comparison 6. Analysis according to report of endoscopic haemostatic treatment
Comparison 7. Analysis restricted to peptic ulcer patients

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

2

580

Odds Ratio (M‐H, Fixed, 95% CI)

1.59 [0.85, 2.97]

2 Rebleeding Show forest plot

2

880

Odds Ratio (M‐H, Fixed, 95% CI)

0.86 [0.59, 1.26]

3 Surgery Show forest plot

2

880

Odds Ratio (M‐H, Fixed, 95% CI)

0.91 [0.59, 1.40]

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Comparison 7. Analysis restricted to peptic ulcer patients