Time-trends in the epidemiology of peptic ulcer bleeding.
OBJECTIVE
Despite the introduction of effective medical treatment of peptic ulcer disease, bleeding is still a frequent complication. The aim of this study was to investigate whether the incidence and the risk profile of peptic ulcer haemorrhage have changed within a 10-year period.


METHODS
In a prospective epidemiological and observational study the incidence and risk profile of peptic ulcer haemorrhage in Düsseldorf, Germany were compared between two time periods (period A: 1.3.89-28.2.90 and period B: 1.4.99-31.3.2000), involving nine hospitals with both surgical and medical departments. Patients with proven peptic ulcer haemorrhage at endoscopy or operation were included in the study; those with bleeding under defined severe stress conditions were excluded.


RESULTS
No differences in bleeding ulcer incidence were observed between periods A and B (51.4 per 100,000 person-years versus 48.7), or for duodenal ulcer (24.9 versus 25.7) or for gastric ulcer bleeding (26.5 versus 23.0). A marked increase in incidence rates was observed with increasing age. In period B, patients with bleeding ulcers were older (56% versus 41% 70 years or older), were usually taking non-steroidal anti-inflammatory drugs (NSAIDs) (45% versus 27%) and were less likely to have a history of ulcer (25% versus 59%) compared with patients in period A.


CONCLUSIONS
The persisting high incidence of peptic ulcer disease is a superimposing of two trends: a higher incidence in the growing population of elderly patient with a higher intake of NSAIDs and a lower incidence among younger patients due to a decrease in incidence and improved medical treatment.
Ohmann
Christian
C
Koordinierungszentrum für Klinische Studien, Heinrich-Heine-Universität. ohmannch@uni-duesseldorf.de
Imhof
Michael
M
Ruppert
Christian
C
Janzik
Ulf
U
Vogt
Christoph
C
Frieling
Thomas
T
Becker
Klaus
K
Neumann
Frank
F
Faust
Stephan
S
Heiler
Klaus
K
Haas
Klaus
K
Jurisch
Rainer
R
Wenzel
Ernst-Günter
EG
Normann
Stefan
S
Bachmann
Oliver
O
Delgadillo
Jorge
J
Seidel
Florian
F
Franke
Claus
C
Lüthen
Reinhard
R
Yang
Qin
Q
Reinhold
Christian
C
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D004381:Duodenal Ulcer / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019370:Observation; D010438:Peptic Ulcer Hemorrhage / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013276:Stomach Ulcer / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D013997:Time Factors