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Mortality from peptic ulcer bleeding: the impact of comorbidity and the use of drugs that promote bleeding.

Åhsberg, Kristina LU ; Höglund, Peter LU and Staël von Holstein, Christer LU (2010) In Alimentary pharmacology & therapeutics 32. p.801-810
Abstract
Summary Background Use of drugs promoting peptic ulcer bleed has increased several folds. Aim To make a time-trend analysis of peptic ulcer bleed patients and evaluate the impact of age, gender, comorbidity and use of drugs promoting peptic ulcer bleed on outcome. Methods Retrospective review of hospitalizations for peptic ulcer bleed at Lund University Hospital during 1984, 1994 and 2004. Univariate analyses between years and multivariable logistic regression for risk factors of fatal outcome. Results Incidence decreased from 62.0 to 32.1 per 100 000 inhabitants between 1984 and 2004. Mortality rates were stable. Median age (70-77 years; P = 0.001), number of comorbidities (mean +/- s.d.: 0.88 +/- 0.96 to 1.16 +/- 0.77; P = 0.021), use of... (More)
Summary Background Use of drugs promoting peptic ulcer bleed has increased several folds. Aim To make a time-trend analysis of peptic ulcer bleed patients and evaluate the impact of age, gender, comorbidity and use of drugs promoting peptic ulcer bleed on outcome. Methods Retrospective review of hospitalizations for peptic ulcer bleed at Lund University Hospital during 1984, 1994 and 2004. Univariate analyses between years and multivariable logistic regression for risk factors of fatal outcome. Results Incidence decreased from 62.0 to 32.1 per 100 000 inhabitants between 1984 and 2004. Mortality rates were stable. Median age (70-77 years; P = 0.001), number of comorbidities (mean +/- s.d.: 0.88 +/- 0.96 to 1.16 +/- 0.77; P = 0.021), use of aspirin (16-57%; P < 0.001) and warfarin (5-17%; P = 0.02) increased. Pharmacological and endoscopic therapy improved. Age above 65 years (OR: 1.11, 95% CI: 1.02-1.23) and number of comorbidities (OR: 6.00, 95% CI: 2.56-17.4) were independent risk factors for in-hospital mortality. Bleeding promoting drugs did not influence outcome negatively. Aspirin decreased the risk of fatal outcome (OR: 0.12, 95% CI: 0.012-0.67). Conclusions Incidence of peptic ulcer bleed decreased despite higher prescription rates of bleeding promoting drugs. The in-hospital mortality remained unchanged. The effect of improved therapy against peptic ulcer bleed is probably outweighed by older and more comorbid patients. The decreased risk of fatal outcome in aspirin users warrants further investigations. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Alimentary pharmacology & therapeutics
volume
32
pages
801 - 810
publisher
Wiley-Blackwell
external identifiers
  • wos:000280972200011
  • pmid:20653635
  • scopus:77955719297
ISSN
1365-2036
DOI
10.1111/j.1365-2036.2010.04399.x
language
English
LU publication?
yes
id
c664d199-3083-41a0-99ea-a70c7d22197e (old id 1644606)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20653635?dopt=Abstract
date added to LUP
2010-08-05 09:47:09
date last changed
2017-01-01 07:45:01
@article{c664d199-3083-41a0-99ea-a70c7d22197e,
  abstract     = {Summary Background Use of drugs promoting peptic ulcer bleed has increased several folds. Aim To make a time-trend analysis of peptic ulcer bleed patients and evaluate the impact of age, gender, comorbidity and use of drugs promoting peptic ulcer bleed on outcome. Methods Retrospective review of hospitalizations for peptic ulcer bleed at Lund University Hospital during 1984, 1994 and 2004. Univariate analyses between years and multivariable logistic regression for risk factors of fatal outcome. Results Incidence decreased from 62.0 to 32.1 per 100 000 inhabitants between 1984 and 2004. Mortality rates were stable. Median age (70-77 years; P = 0.001), number of comorbidities (mean +/- s.d.: 0.88 +/- 0.96 to 1.16 +/- 0.77; P = 0.021), use of aspirin (16-57%; P &lt; 0.001) and warfarin (5-17%; P = 0.02) increased. Pharmacological and endoscopic therapy improved. Age above 65 years (OR: 1.11, 95% CI: 1.02-1.23) and number of comorbidities (OR: 6.00, 95% CI: 2.56-17.4) were independent risk factors for in-hospital mortality. Bleeding promoting drugs did not influence outcome negatively. Aspirin decreased the risk of fatal outcome (OR: 0.12, 95% CI: 0.012-0.67). Conclusions Incidence of peptic ulcer bleed decreased despite higher prescription rates of bleeding promoting drugs. The in-hospital mortality remained unchanged. The effect of improved therapy against peptic ulcer bleed is probably outweighed by older and more comorbid patients. The decreased risk of fatal outcome in aspirin users warrants further investigations.},
  author       = {Åhsberg, Kristina and Höglund, Peter and Staël von Holstein, Christer},
  issn         = {1365-2036},
  language     = {eng},
  pages        = {801--810},
  publisher    = {Wiley-Blackwell},
  series       = {Alimentary pharmacology & therapeutics},
  title        = {Mortality from peptic ulcer bleeding: the impact of comorbidity and the use of drugs that promote bleeding.},
  url          = {http://dx.doi.org/10.1111/j.1365-2036.2010.04399.x},
  volume       = {32},
  year         = {2010},
}