Prospective Survey for the Etiology and Outcome of Peptic Ulcer Bleeding: A Community Based Study in Southern Taiwan
Helicobacter pylori infection and drugs are the two major risk factors for peptic ulcer bleeding. The role of these two factors may change with changes in the prevalence of H pylori and use of NSAIDs. This study aimed to determine the cause, endoscopic features, and outcome of peptic ulcer bleeding...
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| Format: | Article |
| Language: | English |
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Elsevier
2011-04-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S092966461160034X |
| _version_ | 1819158543317598208 |
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| author | Chi-Yang Chang Ming-Shiang Wu Ching-Tai Lee Jau-Chung Hwang Chi-Ming Tai Daw-Shyong Perng Chih-Wen Lin Wen-Lun Wang Jung-Der Wang Jaw-Town Lin |
| author_facet | Chi-Yang Chang Ming-Shiang Wu Ching-Tai Lee Jau-Chung Hwang Chi-Ming Tai Daw-Shyong Perng Chih-Wen Lin Wen-Lun Wang Jung-Der Wang Jaw-Town Lin |
| author_sort | Chi-Yang Chang |
| collection | DOAJ |
| description | Helicobacter pylori infection and drugs are the two major risk factors for peptic ulcer bleeding. The role of these two factors may change with changes in the prevalence of H pylori and use of NSAIDs. This study aimed to determine the cause, endoscopic features, and outcome of peptic ulcer bleeding in a community hospital in southern Taiwan.
Methods: Patients who received esophagogastroduodenoscopy on arrival at the emergency department and were found to have actively bleeding ulcers or ulcers with stigmata of recent hemorrhage were included. H pylori infection was documented by the rapid urease test, histology, and/or C-13 urease breath test. Medication history, comorbidities, requirement for endoscopic therapy, blood transfusion, hospitalization days, and rebleeding rates were analyzed.
Results: A total of 204 patients were enrolled with a mean age of 64.8 ± 15.2 years, with 58.3% of the subjects being female. There were 62 patients (30.4%) with H pylori infection only, 40 patients (19.6%) with drug use only, 67 patients (32.8%) with H pylori infection and drug use, and 37 patients (17.2%) without H pylori or drug use. A total of 107 patients (52.5%) were found to have had drug exposure. Drug exposure had an odds ratio (OR) of 2.34 [95% Confidence Interval (CI) = 1.30-4.20] for gastric ulcer bleeding and H pylori had an OR of 2.64 (95% CI = 1.17-5.97) for combined gastric and duodenal ulcer bleeding. The mean hospitalization period was 5.7 ± 4.0 days and the overall re-bleeding rate was 4.0%. The H pylori negative and drug negative subjects needed more endoscopic therapy (p < 0.05).
Conclusion: Drug use, especially NSAIDs, aspirin, and clopidogrel has become an important cause of peptic ulcer bleeding in southern Taiwan. |
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| format | Article |
| id | doaj.art-04eec3119aee4420a541ae3c53e3fd6d |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-22T16:26:20Z |
| publishDate | 2011-04-01 |
| publisher | Elsevier |
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| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-04eec3119aee4420a541ae3c53e3fd6d2022-12-21T18:20:09ZengElsevierJournal of the Formosan Medical Association0929-66462011-04-01110422322910.1016/S0929-6646(11)60034-XProspective Survey for the Etiology and Outcome of Peptic Ulcer Bleeding: A Community Based Study in Southern TaiwanChi-Yang Chang0Ming-Shiang Wu1Ching-Tai Lee2Jau-Chung Hwang3Chi-Ming Tai4Daw-Shyong Perng5Chih-Wen Lin6Wen-Lun Wang7Jung-Der Wang8Jaw-Town Lin9Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, TaiwanDepartment of Pathology, E-Da Hospital, I-Shou University, Kaohsiung, TaiwanDepartment of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, TaiwanDepartment of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, TaiwanDepartment of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, TaiwanDepartment of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, TaiwanHelicobacter pylori infection and drugs are the two major risk factors for peptic ulcer bleeding. The role of these two factors may change with changes in the prevalence of H pylori and use of NSAIDs. This study aimed to determine the cause, endoscopic features, and outcome of peptic ulcer bleeding in a community hospital in southern Taiwan. Methods: Patients who received esophagogastroduodenoscopy on arrival at the emergency department and were found to have actively bleeding ulcers or ulcers with stigmata of recent hemorrhage were included. H pylori infection was documented by the rapid urease test, histology, and/or C-13 urease breath test. Medication history, comorbidities, requirement for endoscopic therapy, blood transfusion, hospitalization days, and rebleeding rates were analyzed. Results: A total of 204 patients were enrolled with a mean age of 64.8 ± 15.2 years, with 58.3% of the subjects being female. There were 62 patients (30.4%) with H pylori infection only, 40 patients (19.6%) with drug use only, 67 patients (32.8%) with H pylori infection and drug use, and 37 patients (17.2%) without H pylori or drug use. A total of 107 patients (52.5%) were found to have had drug exposure. Drug exposure had an odds ratio (OR) of 2.34 [95% Confidence Interval (CI) = 1.30-4.20] for gastric ulcer bleeding and H pylori had an OR of 2.64 (95% CI = 1.17-5.97) for combined gastric and duodenal ulcer bleeding. The mean hospitalization period was 5.7 ± 4.0 days and the overall re-bleeding rate was 4.0%. The H pylori negative and drug negative subjects needed more endoscopic therapy (p < 0.05). Conclusion: Drug use, especially NSAIDs, aspirin, and clopidogrel has become an important cause of peptic ulcer bleeding in southern Taiwan.http://www.sciencedirect.com/science/article/pii/S092966461160034XetiologyHelicobacter pyloriNSAIDoutcomepeptic ulcer |
| spellingShingle | Chi-Yang Chang Ming-Shiang Wu Ching-Tai Lee Jau-Chung Hwang Chi-Ming Tai Daw-Shyong Perng Chih-Wen Lin Wen-Lun Wang Jung-Der Wang Jaw-Town Lin Prospective Survey for the Etiology and Outcome of Peptic Ulcer Bleeding: A Community Based Study in Southern Taiwan Journal of the Formosan Medical Association etiology Helicobacter pylori NSAID outcome peptic ulcer |
| title | Prospective Survey for the Etiology and Outcome of Peptic Ulcer Bleeding: A Community Based Study in Southern Taiwan |
| title_full | Prospective Survey for the Etiology and Outcome of Peptic Ulcer Bleeding: A Community Based Study in Southern Taiwan |
| title_fullStr | Prospective Survey for the Etiology and Outcome of Peptic Ulcer Bleeding: A Community Based Study in Southern Taiwan |
| title_full_unstemmed | Prospective Survey for the Etiology and Outcome of Peptic Ulcer Bleeding: A Community Based Study in Southern Taiwan |
| title_short | Prospective Survey for the Etiology and Outcome of Peptic Ulcer Bleeding: A Community Based Study in Southern Taiwan |
| title_sort | prospective survey for the etiology and outcome of peptic ulcer bleeding a community based study in southern taiwan |
| topic | etiology Helicobacter pylori NSAID outcome peptic ulcer |
| url | http://www.sciencedirect.com/science/article/pii/S092966461160034X |
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