Risk factors involved in patients with bleeding peptic ulcers: a case-control study.
Our objectives were to (1) identify the risk factors involved in patients with peptic ulcer disease and determine if they predict bleeding in these patients, (2) determine the association between these risk factors, and (3) analyze the cost effectiveness of various tests for Helicobacter pylori (H. pylori). Two-hundred and thirty patients were included in our study between January 2004 and June 2005 (128 bleeding peptic ulcer disease patients constituted the cases, 102 nonbleeding ulcer patients constituted the controls). H. pylori infection was assessed by urease test and biopsy from gastric antrum. There was no statistically significant difference between these groups regarding sex, age, or location of ulcer. Nonsteroidal anti-inflammatory drug (NSAID) use was higher in the case group (P < 0.001), and the rate of H. pylori infection was lower in these patients (P < 0.05). There was no interaction between NSAID use and H. pylori infection in predicting bleeding ulcer risk (P = 0.08). Sensitivity and specificity for urease test in detecting H. pylori was 75% and 99.7%, respectively. So a positive urease test does not need confirmation with biopsy, which is cost effective.
Uppalapati
Sesha S
SS
Department of Internal Medicine, St. Luke's Hospital, 801 Ostrum Street, Bethlehem, PA 18015, USA. spandana_us@yahoo.com
Boylan
James D
JD
Stoltzfus
Jill
J
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003362:Cost-Benefit Analysis; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000382:microbiology; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology* / Q000382:microbiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal