TY - JOUR
T1 - Association between ulcer site and outcome in complicated peptic ulcer disease
T2 - a Danish nationwide cohort study
AU - Lolle, Ida
AU - Møller, Morten Hylander
AU - Rosenstock, Steffen Jais
PY - 2016/10/2
Y1 - 2016/10/2
N2 - Objective: Mortality rates in complicated peptic ulcer disease are high. This study aimed to examine the prognostic importance of ulcer site in patients with peptic ulcer bleeding (PUB) and perforated peptic ulcer (PPU). Materials and methods:Design: a nationwide cohort study with prospective and consecutive data collection. Population: all patients treated for PUB and PPU at Danish hospitals between 2003 and 2014. Data: demographic and clinical data reported to the Danish Clinical Registry of Emergency Surgery. Outcome measures: 90- and 30-d mortality and re-intervention. Statistics: the crude and adjusted association between ulcer site (gastric and duodenal) and the outcome measures of interest were assessed by binary logistic regression analysis. Results: Some 20,059 patients with PUB and 4273 patients with PPU were included; 90-d mortality was 15.3% for PUB and 29.8% for PPU; 30-d mortality was 10.2% and 24.7%, respectively. Duodenal bleeding ulcer, as compared to gastric ulcer (GU), was associated with a significantly increased risk of all-cause mortality within 90 and 30 d, and with re-intervention: adjusted odds ratio (OR) 1.47 (95% confidence interval 1.30–1.67); p < 0.001, OR 1.60 (1.43–1.77); p < 0.001, and OR 1.86 (1.68–2.06); p < 0.001, respectively. There was no difference in outcomes between gastric and duodenal ulcers (DUs) in PPU patients: adjusted OR 0.99 (0.84–1.16); p = 0.698, OR 0.93 (0.78 to 1.10); p = 0.409, and OR 0.97 (0.80–1.19); p = 0.799, respectively. Conclusions: DU site is a significant predictor of death and re-intervention in patients with PUB, as compared to GU site. This does not seem to be the case for patients with PPU.
AB - Objective: Mortality rates in complicated peptic ulcer disease are high. This study aimed to examine the prognostic importance of ulcer site in patients with peptic ulcer bleeding (PUB) and perforated peptic ulcer (PPU). Materials and methods:Design: a nationwide cohort study with prospective and consecutive data collection. Population: all patients treated for PUB and PPU at Danish hospitals between 2003 and 2014. Data: demographic and clinical data reported to the Danish Clinical Registry of Emergency Surgery. Outcome measures: 90- and 30-d mortality and re-intervention. Statistics: the crude and adjusted association between ulcer site (gastric and duodenal) and the outcome measures of interest were assessed by binary logistic regression analysis. Results: Some 20,059 patients with PUB and 4273 patients with PPU were included; 90-d mortality was 15.3% for PUB and 29.8% for PPU; 30-d mortality was 10.2% and 24.7%, respectively. Duodenal bleeding ulcer, as compared to gastric ulcer (GU), was associated with a significantly increased risk of all-cause mortality within 90 and 30 d, and with re-intervention: adjusted odds ratio (OR) 1.47 (95% confidence interval 1.30–1.67); p < 0.001, OR 1.60 (1.43–1.77); p < 0.001, and OR 1.86 (1.68–2.06); p < 0.001, respectively. There was no difference in outcomes between gastric and duodenal ulcers (DUs) in PPU patients: adjusted OR 0.99 (0.84–1.16); p = 0.698, OR 0.93 (0.78 to 1.10); p = 0.409, and OR 0.97 (0.80–1.19); p = 0.799, respectively. Conclusions: DU site is a significant predictor of death and re-intervention in patients with PUB, as compared to GU site. This does not seem to be the case for patients with PPU.
KW - Journal Article
U2 - 10.1080/00365521.2016.1190398
DO - 10.1080/00365521.2016.1190398
M3 - Journal article
C2 - 27248208
SN - 0036-5521
VL - 51
SP - 1165
EP - 1171
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
IS - 10
ER -