Risk factors of peptic ulcer in 4943 inpatients.
BACKGROUND
Over the past few years, major changes have taken place in the treatment of gastroduodenal peptic ulcer.


OBJECTIVE
To evaluate risk factors associated with the incidence of peptic ulcer in inpatients.


METHODS
From 2001 to 2004, the number of prescriptions of H2-antagonists and proton pump inhibitors (PPIs) in each department of Verona University Hospital was monitored. Over the same period we prospectively recorded the number of upper endoscopies per department for inpatients with a diagnosis of peptic ulcer.


RESULTS
We analyzed 4943 inpatients. A significantly decreasing trend in H(2)-antagonist prescriptions (r=-0,88; P<0.001) and an increasing trend in PPI prescriptions (r=0.97; P<0.001) were observed. The endoscopic incidence of duodenal ulcers decreased linearly from 2001 to 2004 as follows: 6.5% (94/1439) in 2001, 5.6% (82/1473) in 2002, 4.5% (63/1411) in 2003, and 3.1% (22/702) (P<0.001) in 2004. Gastric ulcer incidence, sex, age, indication for endoscopy, use of nonsteroidal anti-inflammatory drugs (NSAIDs), presence of Helicobacter pylori (32%), and smoking and drinking habits showed no significant changes over the study period. Considering time-dependent variables, multivariate regression analysis identified only PPI use and NSAID use as factors predictive of duodenal ulcer but not of gastric ulcer.


CONCLUSIONS
In inpatients, PPIs are associated with a reduced risk of duodenal ulcer, whereas NSAIDs are associated with an increased risk. Gastric ulcer was not associated with any increased or degreased risk with the 2 above-mentioned variables.
Talamini
Giorgio
G
Gastroenterology and Endoscopy Unit, Department of Internal Medicine, University of Verona, Verona, Italy. giorgio.talamini@univr.it
Tommasi
Marina
M
Amadei
Valeria
V
Pajusco
Benedetta
B
Fratucello
Anna
A
Lechi
Alessandro
A
Scroccaro
Giovanna
G
Vantini
Italo
I
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D004381:Duodenal Ulcer / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013276:Stomach Ulcer / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal